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This is VAERS ID 902903

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 902903
VAERS Form:2
Age:54.0
Sex:Female
Location:North Carolina
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Military      Purchased by: ??
Symptoms: Erythema, Oedema peripheral, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: Hives - anthrax, flu unknown brand
Other Medications: Lotrel, Zyrtec, Zoloft, Albuterol and Prilosec
Current Illness: None reported
Preexisting Conditions: Asthma, Hypertension
Allergies: PCN, Lexapro
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Hives within 3 hours lasted 12 hours. Left Arm edema and erythema 24 hours


Changed on 12/24/2020

VAERS ID: 902903 Before After
VAERS Form:2
Age:54.0
Sex:Female
Location:North Carolina
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Military      Purchased by: ??
Symptoms: Erythema, Oedema peripheral, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: Hives - anthrax, flu unknown brand
Other Medications: Lotrel, Zyrtec, Zoloft, Albuterol and Prilosec
Current Illness: None reported
Preexisting Conditions: Asthma, Hypertension
Allergies: PCN, Lexapro Lexapro
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Hives within 3 hours lasted 12 hours. Left Arm edema and erythema 24 hours


Changed on 12/30/2020

VAERS ID: 902903 Before After
VAERS Form:2
Age:54.0
Sex:Female
Location:North Carolina
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Military      Purchased by: ??
Symptoms: Erythema, Oedema peripheral, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: Hives - anthrax, flu unknown brand
Other Medications: Lotrel, Zyrtec, Zoloft, Albuterol and Prilosec
Current Illness: None reported
Preexisting Conditions: Asthma, Hypertension
Allergies: PCN, Lexapro Lexapro
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Hives within 3 hours lasted 12 hours. Left Arm edema and erythema 24 hours


Changed on 5/7/2021

VAERS ID: 902903 Before After
VAERS Form:2
Age:54.0
Sex:Female
Location:North Carolina
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Military      Purchased by: ??
Symptoms: Erythema, Oedema peripheral, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: Hives - anthrax, flu unknown brand
Other Medications: Lotrel, Zyrtec, Zoloft, Albuterol and Prilosec
Current Illness: None reported
Preexisting Conditions: Asthma, Hypertension
Allergies: PCN, Lexapro Lexapro
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Hives within 3 hours lasted 12 hours. Left Arm edema and erythema 24 hours


Changed on 5/14/2021

VAERS ID: 902903 Before After
VAERS Form:2
Age:54.0
Sex:Female
Location:North Carolina
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Military      Purchased by: ??
Symptoms: Erythema, Oedema peripheral, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: Hives - anthrax, flu unknown brand
Other Medications: Lotrel, Zyrtec, Zoloft, Albuterol and Prilosec
Current Illness: None reported
Preexisting Conditions: Asthma, Hypertension
Allergies: PCN, Lexapro Lexapro
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Hives within 3 hours lasted 12 hours. Left Arm edema and erythema 24 hours

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