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This is VAERS ID 902674

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 902674
VAERS Form:2
Age:38.0
Sex:Female
Location:Wyoming
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Hyperhidrosis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Current Illness: none
Preexisting Conditions: none
Allergies: Doxycycline
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient has a prior anaphylaxis reaction to Doxycycline. 10minutes after immunization, she developed sweaty palms and lightheadedness. No throat swelling or difficulty breathing. Placed supine, BP 160/100, HR 60-70, O2 97% RA. After a period of monitoring the symptoms improved. No intervention given.


Changed on 12/24/2020

VAERS ID: 902674 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:Wyoming
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Hyperhidrosis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Current Illness: none
Preexisting Conditions: none
Allergies: Doxycycline Doxycycline
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient has a prior anaphylaxis reaction to Doxycycline. 10minutes after immunization, she developed sweaty palms and lightheadedness. No throat swelling or difficulty breathing. Placed supine, BP 160/100, HR 60-70, O2 97% RA. After a period of monitoring the symptoms improved. No intervention given.


Changed on 12/30/2020

VAERS ID: 902674 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:Wyoming
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Hyperhidrosis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Current Illness: none
Preexisting Conditions: none
Allergies: Doxycycline Doxycycline
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient has a prior anaphylaxis reaction to Doxycycline. 10minutes after immunization, she developed sweaty palms and lightheadedness. No throat swelling or difficulty breathing. Placed supine, BP 160/100, HR 60-70, O2 97% RA. After a period of monitoring the symptoms improved. No intervention given.


Changed on 5/7/2021

VAERS ID: 902674 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:Wyoming
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Hyperhidrosis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Current Illness: none
Preexisting Conditions: none
Allergies: Doxycycline Doxycycline
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient has a prior anaphylaxis reaction to Doxycycline. 10minutes after immunization, she developed sweaty palms and lightheadedness. No throat swelling or difficulty breathing. Placed supine, BP 160/100, HR 60-70, O2 97% RA. After a period of monitoring the symptoms improved. No intervention given.


Changed on 5/14/2021

VAERS ID: 902674 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:Wyoming
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Hyperhidrosis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Current Illness: none
Preexisting Conditions: none
Allergies: Doxycycline Doxycycline
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient has a prior anaphylaxis reaction to Doxycycline. 10minutes after immunization, she developed sweaty palms and lightheadedness. No throat swelling or difficulty breathing. Placed supine, BP 160/100, HR 60-70, O2 97% RA. After a period of monitoring the symptoms improved. No intervention given.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=902674&WAYBACKHISTORY=ON


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