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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 902932 |
VAERS Form: | 2 |
Age: | 52.0 |
Sex: | Female |
Location: | Unknown |
Vaccinated: | 2020-12-17 |
Onset: | 2020-12-17 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-17 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EK5730 / 1 | LA / IM |
Administered by: Unknown Purchased by: ??
Symptoms: Dizziness, Flushing, Pruritus, Immediate post-injection reaction
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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Patient reports of itching immediately after vaccine, dizzy, feeling of flush. Medical directive given for itching that include OTC antihistamine (Claritin). Incident Management team activated for dizziness and feeling of flush.
Vaccinated: | 2020-12-17 |
Onset: | 2020-12-17 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-17 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EK5730 / 1 | LA / IM |
Administered by: Unknown Purchased by: ??
Symptoms: Dizziness, Flushing, Pruritus, Immediate post-injection reaction
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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) VSafe
Write-up: Patient reports of itching immediately after vaccine, dizzy, feeling of flush. Medical directive given for itching that include OTC antihistamine (Claritin). Incident Management team activated for dizziness and feeling of flush.
Vaccinated: | 2020-12-17 |
Onset: | 2020-12-17 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-17 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EK5730 / 1 | LA / IM |
Administered by: Unknown Purchased by: ??
Symptoms: Dizziness, Flushing, Pruritus, Immediate post-injection reaction
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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': VSafe (blank)
Write-up: Patient reports of itching immediately after vaccine, dizzy, feeling of flush. Medical directive given for itching that include OTC antihistamine (Claritin). Incident Management team activated for dizziness and feeling of flush.
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