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This is VAERS ID 902764

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 902764
VAERS Form:2
Age:71.0
Sex:Female
Location:North Carolina
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 EK5730 / UNK - / -

Administered by: Military      Purchased by: ??
Symptoms: Injection site bruising, 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: Levothyroxine 88MCG/once daily, Losartan 100MG/once daily, PravastatinSodium 20MG/once daily, Protonix40MG/twice daily, aspirin 81MG/once daily, Calcium1000, Magnesium400,Zinc15/once daily
Current Illness: None
Preexisting Conditions: Controlled by medication: high blood pressure, thyroid, heartburn, leg cramps
Allergies: None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: .5 inch bruise at injection site, slight swelling, sore muscle, ibuprofen, ice bag,


Changed on 12/24/2020

VAERS ID: 902764 Before After
VAERS Form:2
Age:71.0
Sex:Female
Location:North Carolina
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 EK5730 / UNK - / -

Administered by: Military      Purchased by: ??
Symptoms: Injection site bruising, 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: Levothyroxine 88MCG/once daily, Losartan 100MG/once daily, PravastatinSodium 20MG/once daily, Protonix40MG/twice daily, aspirin 81MG/once daily, Calcium1000, Magnesium400,Zinc15/once daily
Current Illness: None
Preexisting Conditions: Controlled by medication: high blood pressure, thyroid, heartburn, leg cramps
Allergies: None None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: .5 inch bruise at injection site, slight swelling, sore muscle, ibuprofen, ice bag,


Changed on 12/30/2020

VAERS ID: 902764 Before After
VAERS Form:2
Age:71.0
Sex:Female
Location:North Carolina
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 EK5730 / UNK - / -

Administered by: Military      Purchased by: ??
Symptoms: Injection site bruising, 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: Levothyroxine 88MCG/once daily, Losartan 100MG/once daily, PravastatinSodium 20MG/once daily, Protonix40MG/twice daily, aspirin 81MG/once daily, Calcium1000, Magnesium400,Zinc15/once daily
Current Illness: None
Preexisting Conditions: Controlled by medication: high blood pressure, thyroid, heartburn, leg cramps
Allergies: None None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: .5 inch bruise at injection site, slight swelling, sore muscle, ibuprofen, ice bag,


Changed on 5/7/2021

VAERS ID: 902764 Before After
VAERS Form:2
Age:71.0
Sex:Female
Location:North Carolina
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 EK5730 / UNK - / -

Administered by: Military      Purchased by: ??
Symptoms: Injection site bruising, 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: Levothyroxine 88MCG/once daily, Losartan 100MG/once daily, PravastatinSodium 20MG/once daily, Protonix40MG/twice daily, aspirin 81MG/once daily, Calcium1000, Magnesium400,Zinc15/once daily
Current Illness: None
Preexisting Conditions: Controlled by medication: high blood pressure, thyroid, heartburn, leg cramps
Allergies: None None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: .5 inch bruise at injection site, slight swelling, sore muscle, ibuprofen, ice bag,


Changed on 5/14/2021

VAERS ID: 902764 Before After
VAERS Form:2
Age:71.0
Sex:Female
Location:North Carolina
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 EK5730 / UNK - / -

Administered by: Military      Purchased by: ??
Symptoms: Injection site bruising, 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: Levothyroxine 88MCG/once daily, Losartan 100MG/once daily, PravastatinSodium 20MG/once daily, Protonix40MG/twice daily, aspirin 81MG/once daily, Calcium1000, Magnesium400,Zinc15/once daily
Current Illness: None
Preexisting Conditions: Controlled by medication: high blood pressure, thyroid, heartburn, leg cramps
Allergies: None None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: .5 inch bruise at injection site, slight swelling, sore muscle, ibuprofen, ice bag,

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