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This is VAERS ID 1376380

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1376380
VAERS Form:2
Age:14.0
Sex:Female
Location:Michigan
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dysphagia, Throat tightness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Additional Details: patient was having given epipen then felt better but called 911 then they took her since epipen was administered but while leaving the pharmacy she was in good condition feeling better no need to administer 2nd dose of epipen

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1376380&WAYBACKHISTORY=ON


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