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This is VAERS ID 1700080

History of Changes from the VAERS Wayback Machine

First Appeared on 9/17/2021

VAERS ID: 1700080
VAERS Form:2
Age:55.0
Sex:Female
Location:New York
Vaccinated:2021-09-14
Onset:2021-09-14
Submitted:0000-00-00
Entered:2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Asthenia, Muscular weakness, Paraesthesia oral

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: Reported anaphylactic reaction to Flu vaccine at age 48. Went to ER Epinephrine administered
Other Medications: none Reported
Current Illness: n/a
Preexisting Conditions: Anemia DVT
Allergies: Tetracycline
Diagnostic Lab Data: Unkown
CDC 'Split Type':

Write-up: 5 minutes after administration employee c/o of generalized weakness especially in legs. Employee placed in semi fowlers position and monitored. Approximately 56 mins after administration employee c/o tingling to lips and tongue, 25mg of Benadryl given im with relief. Employee transported via ambulance to Hospital ER.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1700080&WAYBACKHISTORY=ON

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