National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 902667

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 902667
VAERS Form:2
Age:44.0
Sex:Female
Location:Colorado
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / N/A LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site erythema, Injection site induration, Local reaction

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After patient received vaccine had localized reaction in left deltoid. Redness and firm to touch. Patient observed for additional time frame and redness lessened. Patient released home.


Changed on 12/24/2020

VAERS ID: 902667 Before After
VAERS Form:2
Age:44.0
Sex:Female
Location:Colorado
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / N/A LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site erythema, Injection site induration, Local reaction

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After patient received vaccine had localized reaction in left deltoid. Redness and firm to touch. Patient observed for additional time frame and redness lessened. Patient released home.


Changed on 12/30/2020

VAERS ID: 902667 Before After
VAERS Form:2
Age:44.0
Sex:Female
Location:Colorado
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / N/A LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site erythema, Injection site induration, Local reaction

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After patient received vaccine had localized reaction in left deltoid. Redness and firm to touch. Patient observed for additional time frame and redness lessened. Patient released home.


Changed on 5/7/2021

VAERS ID: 902667 Before After
VAERS Form:2
Age:44.0
Sex:Female
Location:Colorado
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / N/A LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site erythema, Injection site induration, Local reaction

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After patient received vaccine had localized reaction in left deltoid. Redness and firm to touch. Patient observed for additional time frame and redness lessened. Patient released home.


Changed on 5/14/2021

VAERS ID: 902667 Before After
VAERS Form:2
Age:44.0
Sex:Female
Location:Colorado
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / N/A LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site erythema, Injection site induration, Local reaction

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After patient received vaccine had localized reaction in left deltoid. Redness and firm to touch. Patient observed for additional time frame and redness lessened. Patient released home.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=902667&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166