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This is VAERS ID 902770

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 902770
VAERS Form:2
Age:50.0
Sex:Female
Location:Arkansas
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 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Pruritus, Rash maculo-papular

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Lisinopril, Loracarbef, warfarin, Bydureon pen
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient started to develop maculopapular rash and itching starting ~15 minutes after the vaccine administration. The patient did not report shortness of breath or other respiratory symptoms. The patient was given IV diphenhydramine 50 mg, famotidine 20 mg IV, and methylprednisolone 125 mg IV. The patient''s symptoms resolved and was sent home with a Medrol dose pack and antihistamine.


Changed on 12/24/2020

VAERS ID: 902770 Before After
VAERS Form:2
Age:50.0
Sex:Female
Location:Arkansas
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 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Pruritus, Rash maculo-papular

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Lisinopril, Loracarbef, warfarin, Bydureon pen pen
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient started to develop maculopapular rash and itching starting ~15 minutes after the vaccine administration. The patient did not report shortness of breath or other respiratory symptoms. The patient was given IV diphenhydramine 50 mg, famotidine 20 mg IV, and methylprednisolone 125 mg IV. The patient''s symptoms resolved and was sent home with a Medrol dose pack and antihistamine.


Changed on 12/30/2020

VAERS ID: 902770 Before After
VAERS Form:2
Age:50.0
Sex:Female
Location:Arkansas
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 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Pruritus, Rash maculo-papular

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Lisinopril, Loracarbef, warfarin, Bydureon pen pen
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient started to develop maculopapular rash and itching starting ~15 minutes after the vaccine administration. The patient did not report shortness of breath or other respiratory symptoms. The patient was given IV diphenhydramine 50 mg, famotidine 20 mg IV, and methylprednisolone 125 mg IV. The patient''s symptoms resolved and was sent home with a Medrol dose pack and antihistamine.


Changed on 5/7/2021

VAERS ID: 902770 Before After
VAERS Form:2
Age:50.0
Sex:Female
Location:Arkansas
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 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Pruritus, Rash maculo-papular

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Lisinopril, Loracarbef, warfarin, Bydureon pen pen
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient started to develop maculopapular rash and itching starting ~15 minutes after the vaccine administration. The patient did not report shortness of breath or other respiratory symptoms. The patient was given IV diphenhydramine 50 mg, famotidine 20 mg IV, and methylprednisolone 125 mg IV. The patient''s symptoms resolved and was sent home with a Medrol dose pack and antihistamine.


Changed on 5/14/2021

VAERS ID: 902770 Before After
VAERS Form:2
Age:50.0
Sex:Female
Location:Arkansas
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 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Pruritus, Rash maculo-papular

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Lisinopril, Loracarbef, warfarin, Bydureon pen pen
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient started to develop maculopapular rash and itching starting ~15 minutes after the vaccine administration. The patient did not report shortness of breath or other respiratory symptoms. The patient was given IV diphenhydramine 50 mg, famotidine 20 mg IV, and methylprednisolone 125 mg IV. The patient''s symptoms resolved and was sent home with a Medrol dose pack and antihistamine.

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