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This is VAERS ID 1775197

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1775197
VAERS Form:2
Age:39.0
Sex:Female
Location:Texas
Vaccinated:2021-10-08
Onset:2021-10-09
Submitted:0000-00-00
Entered:2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chills, Headache, Lethargy, Nausea, Pain, Pyrexia, Extra dose administered

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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Shellfish, pcn
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Body aches, headache, chills, nausea, lethargy, Low grade fever (100.2 oral)

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