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This is VAERS ID 902514

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 902514
VAERS Form:2
Age:25.0
Sex:Female
Location:Texas
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 EK5730 / 1 RA / IM

Administered by: Work      Purchased by: ??
Symptoms: Inappropriate schedule of product administration

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: N/A
Current Illness: N/A
Preexisting Conditions: none documented
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: System was not populating immunization record, member denied having immunizations within last 14 days. Vaccine given, record populated and patient had anthrax on 12/10/20


Changed on 12/24/2020

VAERS ID: 902514 Before After
VAERS Form:2
Age:25.0
Sex:Female
Location:Texas
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 EK5730 / 1 RA / IM

Administered by: Work      Purchased by: ??
Symptoms: Inappropriate schedule of product administration

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: N/A
Current Illness: N/A
Preexisting Conditions: none documented
Allergies: NKA NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: System was not populating immunization record, member denied having immunizations within last 14 days. Vaccine given, record populated and patient had anthrax on 12/10/20


Changed on 12/30/2020

VAERS ID: 902514 Before After
VAERS Form:2
Age:25.0
Sex:Female
Location:Texas
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 EK5730 / 1 RA / IM

Administered by: Work      Purchased by: ??
Symptoms: Inappropriate schedule of product administration

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: N/A
Current Illness: N/A
Preexisting Conditions: none documented
Allergies: NKA NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: System was not populating immunization record, member denied having immunizations within last 14 days. Vaccine given, record populated and patient had anthrax on 12/10/20


Changed on 5/7/2021

VAERS ID: 902514 Before After
VAERS Form:2
Age:25.0
Sex:Female
Location:Texas
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 EK5730 / 1 RA / IM

Administered by: Work      Purchased by: ??
Symptoms: Inappropriate schedule of product administration

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: N/A
Current Illness: N/A
Preexisting Conditions: none documented
Allergies: NKA NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: System was not populating immunization record, member denied having immunizations within last 14 days. Vaccine given, record populated and patient had anthrax on 12/10/20


Changed on 5/14/2021

VAERS ID: 902514 Before After
VAERS Form:2
Age:25.0
Sex:Female
Location:Texas
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 EK5730 / 1 RA / IM

Administered by: Work      Purchased by: ??
Symptoms: Inappropriate schedule of product administration

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: N/A
Current Illness: N/A
Preexisting Conditions: none documented
Allergies: NKA NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: System was not populating immunization record, member denied having immunizations within last 14 days. Vaccine given, record populated and patient had anthrax on 12/10/20

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