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This is VAERS ID 1778752

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1778752
VAERS Form:2
Age:14.0
Sex:Female
Location:Michigan
Vaccinated:2021-10-08
Onset:2021-10-09
Submitted:0000-00-00
Entered:2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 UN / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest pain, Dyspnoea, Mobility decreased

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: Celexa and birth control
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt stated that she had extreme difficulty breathing and chest pain the next day after her shot. She stated that she stayed in bed all day. Today is 10-12-21 and is complaining of continuous chest pain. Suggesting that she sees her PCP$g

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