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This is VAERS ID 902763

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 902763
VAERS Form:2
Age:59.0
Sex:Female
Location:Rhode Island
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 EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site pain, Injection site swelling

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: HCTZ, gabapentin
Current Illness: None
Preexisting Conditions:
Allergies: latex, thimerosal
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Soreness and swelling at injection site


Changed on 12/24/2020

VAERS ID: 902763 Before After
VAERS Form:2
Age:59.0
Sex:Female
Location:Rhode Island
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 EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site pain, Injection site swelling

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: HCTZ, gabapentin
Current Illness: None
Preexisting Conditions:
Allergies: latex, thimerosal thimerosal
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Soreness and swelling at injection site


Changed on 12/30/2020

VAERS ID: 902763 Before After
VAERS Form:2
Age:59.0
Sex:Female
Location:Rhode Island
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 EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site pain, Injection site swelling

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: HCTZ, gabapentin
Current Illness: None
Preexisting Conditions:
Allergies: latex, thimerosal thimerosal
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Soreness and swelling at injection site


Changed on 5/7/2021

VAERS ID: 902763 Before After
VAERS Form:2
Age:59.0
Sex:Female
Location:Rhode Island
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 EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site pain, Injection site swelling

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: HCTZ, gabapentin
Current Illness: None
Preexisting Conditions:
Allergies: latex, thimerosal thimerosal
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Soreness and swelling at injection site


Changed on 5/14/2021

VAERS ID: 902763 Before After
VAERS Form:2
Age:59.0
Sex:Female
Location:Rhode Island
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 EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site pain, Injection site swelling

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: HCTZ, gabapentin
Current Illness: None
Preexisting Conditions:
Allergies: latex, thimerosal thimerosal
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Soreness and swelling at injection site

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