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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 902766 |
VAERS Form: | 2 |
Age: | 65.0 |
Sex: | Female |
Location: | Missouri |
Vaccinated: | 2020-12-16 |
Onset: | 2020-12-16 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-16 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EH9899 / 1 | RA / IM |
Administered by: Work Purchased by: ??
Symptoms: Chest discomfort, Cough, Wheelchair user, Immediate post-injection reaction, Vaccination site haemorrhage, Vaccination site bruising
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillins, Crestor (Rosuvastatin)
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Vaccinator Nurse noted upon vaccination there was bleeding from site and immediate bruising. Extended post vaccination monitoring to 30 minutes and asked patient to not leave before being reevaluated. Visual monitoring in post vaccination space by this RN. ? Upon reassessment @ 1352 pt stated she felt the need to use her inhaler and chest tightness. Pt denies SOB and able to transfer independently to wheelchair. Pt began to cough and was immediately transferred to ED per FNP. ? ? Upon ED arrival, pt was transferred to back hall 9, report given to RN and assessed by physician. Vital signs 98% on RA, t- 98.2, HR 78.
Vaccinated: | 2020-12-16 |
Onset: | 2020-12-16 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-16 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EH9899 / 1 | RA / IM |
Administered by: Work Purchased by: ??
Symptoms: Chest discomfort, Cough, Wheelchair user, Immediate post-injection reaction, Vaccination site haemorrhage, Vaccination site bruising
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillins, Crestor (Rosuvastatin)
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Vaccinator Nurse noted upon vaccination there was bleeding from site and immediate bruising. Extended post vaccination monitoring to 30 minutes and asked patient to not leave before being reevaluated. Visual monitoring in post vaccination space by this RN. ? Upon reassessment @ 1352 pt stated she felt the need to use her inhaler and chest tightness. Pt denies SOB and able to transfer independently to wheelchair. Pt began to cough and was immediately transferred to ED per FNP. ? ? Upon ED arrival, pt was transferred to back hall 9, report given to RN and assessed by physician. Vital signs 98% on RA, t- 98.2, HR 78.
Vaccinated: | 2020-12-16 |
Onset: | 2020-12-16 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-16 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EH9899 / 1 | RA / IM |
Administered by: Work Purchased by: ??
Symptoms: Chest discomfort, Cough, Wheelchair user, Immediate post-injection reaction, Vaccination site haemorrhage, Vaccination site bruising
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillins, Crestor (Rosuvastatin)
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Vaccinator Nurse noted upon vaccination there was bleeding from site and immediate bruising. Extended post vaccination monitoring to 30 minutes and asked patient to not leave before being reevaluated. Visual monitoring in post vaccination space by this RN. ? Upon reassessment @ 1352 pt stated she felt the need to use her inhaler and chest tightness. Pt denies SOB and able to transfer independently to wheelchair. Pt began to cough and was immediately transferred to ED per FNP. ? ? Upon ED arrival, pt was transferred to back hall 9, report given to RN and assessed by physician. Vital signs 98% on RA, t- 98.2, HR 78.
Vaccinated: | 2020-12-16 |
Onset: | 2020-12-16 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-16 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EH9899 / 1 | RA / IM |
Administered by: Work Purchased by: ??
Symptoms: Chest discomfort, Cough, Wheelchair user, Immediate post-injection reaction, Vaccination site haemorrhage, Vaccination site bruising
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillins, Crestor (Rosuvastatin)
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Vaccinator Nurse noted upon vaccination there was bleeding from site and immediate bruising. Extended post vaccination monitoring to 30 minutes and asked patient to not leave before being reevaluated. Visual monitoring in post vaccination space by this RN. ? Upon reassessment @ 1352 pt stated she felt the need to use her inhaler and chest tightness. Pt denies SOB and able to transfer independently to wheelchair. Pt began to cough and was immediately transferred to ED per FNP. ? ? Upon ED arrival, pt was transferred to back hall 9, report given to RN and assessed by physician. Vital signs 98% on RA, t- 98.2, HR 78.
Vaccinated: | 2020-12-16 |
Onset: | 2020-12-16 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-16 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EH9899 / 1 | RA / IM |
Administered by: Work Purchased by: ??
Symptoms: Chest discomfort, Cough, Wheelchair user, Immediate post-injection reaction, Vaccination site haemorrhage, Vaccination site bruising
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillins, Crestor (Rosuvastatin)
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Vaccinator Nurse noted upon vaccination there was bleeding from site and immediate bruising. Extended post vaccination monitoring to 30 minutes and asked patient to not leave before being reevaluated. Visual monitoring in post vaccination space by this RN. ? Upon reassessment @ 1352 pt stated she felt the need to use her inhaler and chest tightness. Pt denies SOB and able to transfer independently to wheelchair. Pt began to cough and was immediately transferred to ED per FNP. ? ? Upon ED arrival, pt was transferred to back hall 9, report given to RN and assessed by physician. Vital signs 98% on RA, t- 98.2, HR 78.
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