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This is VAERS ID 1777565

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1777565
VAERS Form:2
Age:70.0
Sex:Female
Location:Minnesota
Vaccinated:2021-02-11
Onset:2021-10-09
Submitted:0000-00-00
Entered:2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 - / -

Administered by: Private      Purchased by: ??
Symptoms: Condition aggravated, Cough, Headache, Pain, Sinus congestion, Respiratory tract congestion

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: Fluticasone; ProAir; Fluorouracil cream; diazepam; lisinopril; amitriptyline; vitamin d3
Current Illness: none
Preexisting Conditions: Arnold chiari malformation; imbalance; basal cell carcinoma; GERD; chronic headaches; multiple allergies; vitamin D deficiency; mild depressioin; COPD; HTN
Allergies: penicillin drugs
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: chest congestion, sinus congestion, headaches, body aches, cough. starting on 10/9/21

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