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This is VAERS ID 1717364

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/24/2021

VAERS ID: 1717364
VAERS Form:2
Age:37.0
Sex:Female
Location:Tennessee
Vaccinated:2021-09-11
Onset:2021-09-13
Submitted:0000-00-00
Entered:2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest pain, Diarrhoea, Dizziness, Fatigue, Headache, Injection site pain, Nausea, Pyrexia, Rash, Tongue eruption

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: Hydrocodone-Acetaminophen Gabapentin Synthroid Vit B12 Vit D2 Zyrtec Benadryl Vyvanse Meloxicam Hydrochlorothiazide Buspirone Allergy Injections
Current Illness: N/A
Preexisting Conditions: Back Pain
Allergies: Latex Vinyl Hay Seasonal Allergies
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Bumps On Back Of Tongue & Throat Chest Pain Dizziness Nauseous Diarrhea Fever Headache Exhaustion Pain At Injection Site

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