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This is VAERS ID 1185470

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1185470
VAERS Form:2
Age:56.0
Sex:Female
Location:New York
Vaccinated:2021-04-09
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Public      Purchased by: ??
Symptoms: Chest pain, Confusional state, Gait disturbance, Pruritus

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Methotrexate and Biologic product for Rheumatoid Arthritis
Current Illness: none
Preexisting Conditions: Rheumatoid arthritis
Allergies: Sulfa, Albuterol, PCN
Diagnostic Lab Data: none done.
CDC 'Split Type':

Write-up: 57 y/o with Past Medical History of Rheumatoid Arthritis on Methotrexate and a biologic medication completed her 15 minute observation period post administration of her 2nd Pfizer COVID vaccination. As she walked out and she began listing to the right side. She sat down, confused, and complaining of chest pain. She also noted pruritus over her face and scalp. No c/o Shortness of Breath, wheezing or nausea. She was immediately evaluated by me and EMT''s . Vital signs demonstrated a HR of 74 in sinus rhythm, O2 Sat of 98% and BP was 192/104. She did not have a rash but was scratching at pruritic areas on scalp and face. See continuation page...


Changed on 5/7/2021

VAERS ID: 1185470 Before After
VAERS Form:2
Age:56.0
Sex:Female
Location:New York
Vaccinated:2021-04-09
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Public      Purchased by: ??
Symptoms: Chest pain, Confusional state, Gait disturbance, Pruritus

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Methotrexate and Biologic product for Rheumatoid Arthritis
Current Illness: none
Preexisting Conditions: Rheumatoid arthritis
Allergies: Sulfa, Albuterol, PCN PCN
Diagnostic Lab Data: none done.
CDC 'Split Type':

Write-up: 57 y/o with Past Medical History of Rheumatoid Arthritis on Methotrexate and a biologic medication completed her 15 minute observation period post administration of her 2nd Pfizer COVID vaccination. As she walked out and she began listing to the right side. She sat down, confused, and complaining of chest pain. She also noted pruritus over her face and scalp. No c/o Shortness of Breath, wheezing or nausea. She was immediately evaluated by me and EMT''s . Vital signs demonstrated a HR of 74 in sinus rhythm, O2 Sat of 98% and BP was 192/104. She did not have a rash but was scratching at pruritic areas on scalp and face. See continuation page...


Changed on 5/14/2021

VAERS ID: 1185470 Before After
VAERS Form:2
Age:56.0
Sex:Female
Location:New York
Vaccinated:2021-04-09
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Public      Purchased by: ??
Symptoms: Chest pain, Confusional state, Gait disturbance, Pruritus

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Methotrexate and Biologic product for Rheumatoid Arthritis
Current Illness: none
Preexisting Conditions: Rheumatoid arthritis
Allergies: Sulfa, Albuterol, PCN PCN
Diagnostic Lab Data: none done.
CDC 'Split Type':

Write-up: 57 y/o with Past Medical History of Rheumatoid Arthritis on Methotrexate and a biologic medication completed her 15 minute observation period post administration of her 2nd Pfizer COVID vaccination. As she walked out and she began listing to the right side. She sat down, confused, and complaining of chest pain. She also noted pruritus over her face and scalp. No c/o Shortness of Breath, wheezing or nausea. She was immediately evaluated by me and EMT''s . Vital signs demonstrated a HR of 74 in sinus rhythm, O2 Sat of 98% and BP was 192/104. She did not have a rash but was scratching at pruritic areas on scalp and face. See continuation page...

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