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This is VAERS ID 1771943

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1771943
VAERS Form:2
Age:26.0
Sex:Female
Location:Virginia
Vaccinated:2021-10-01
Onset:2021-10-04
Submitted:0000-00-00
Entered:2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 3015582 / 3 LA / SYR

Administered by: Work      Purchased by: ??
Symptoms: Chest pain, Dyspnoea, Echocardiogram, Electrocardiogram, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xyzal twice daily, 40mg pepcid BID, 2000 Vitamin D, Iron, Flovent, Dynamist 1 spray BID, singulair at bedtime, and zoloft daily.
Current Illness: General cold two weeks prior. Shortness of breath from pre-existing condition.
Preexisting Conditions: Chronic idiopathic urticaria, asthma.
Allergies: Dapsone, Xolair, Methotrexate, plaquenil, and amoxicillin, severe beef and severe pork.
Diagnostic Lab Data: EKG 10/7, Echo 10/8
CDC 'Split Type':

Write-up: Severe shortness of breath while peak flow was 470 and O2 was 98%. Sharp chest pain on the left side on october 4 which has continued but become an ache.

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