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This is VAERS ID 902490

History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 902490
VAERS Form:2
Age:37.0
Sex:Female
Location:New Mexico
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Headache, Pain

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: Benzoyl peroxide 10% gel, Biofreeze topical gel, Cyclobenzaprine 10mg tab, moisturizing cream, naproxen 250 mg tab, ondansetrn 4mg ODT tab, Refresh Tears
Current Illness: None
Preexisting Conditions: acne, astigmatism, myopia
Allergies: NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Headache, body ache


Changed on 12/24/2020

VAERS ID: 902490 Before After
VAERS Form:2
Age:37.0
Sex:Female
Location:New Mexico
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Headache, Pain

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: Benzoyl peroxide 10% gel, Biofreeze topical gel, Cyclobenzaprine 10mg tab, moisturizing cream, naproxen 250 mg tab, ondansetrn 4mg ODT tab, Refresh Tears
Current Illness: None
Preexisting Conditions: acne, astigmatism, myopia
Allergies: NKDA NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Headache, body ache


Changed on 12/30/2020

VAERS ID: 902490 Before After
VAERS Form:2
Age:37.0
Sex:Female
Location:New Mexico
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Headache, Pain

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: Benzoyl peroxide 10% gel, Biofreeze topical gel, Cyclobenzaprine 10mg tab, moisturizing cream, naproxen 250 mg tab, ondansetrn 4mg ODT tab, Refresh Tears
Current Illness: None
Preexisting Conditions: acne, astigmatism, myopia
Allergies: NKDA NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Headache, body ache


Changed on 5/7/2021

VAERS ID: 902490 Before After
VAERS Form:2
Age:37.0
Sex:Female
Location:New Mexico
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Headache, Pain

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: Benzoyl peroxide 10% gel, Biofreeze topical gel, Cyclobenzaprine 10mg tab, moisturizing cream, naproxen 250 mg tab, ondansetrn 4mg ODT tab, Refresh Tears
Current Illness: None
Preexisting Conditions: acne, astigmatism, myopia
Allergies: NKDA NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Headache, body ache


Changed on 5/14/2021

VAERS ID: 902490 Before After
VAERS Form:2
Age:37.0
Sex:Female
Location:New Mexico
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Headache, Pain

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: Benzoyl peroxide 10% gel, Biofreeze topical gel, Cyclobenzaprine 10mg tab, moisturizing cream, naproxen 250 mg tab, ondansetrn 4mg ODT tab, Refresh Tears
Current Illness: None
Preexisting Conditions: acne, astigmatism, myopia
Allergies: NKDA NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Headache, body ache

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