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This is VAERS ID 903112

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 903112
VAERS Form:2
Age:44.0
Sex:Female
Location:Arkansas
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Electrocardiogram abnormal, Flushing, Heart rate irregular, Palpitations, Ventricular extrasystoles

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: solifenacin, fluticasone, loratadine
Current Illness:
Preexisting Conditions:
Allergies: codeine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient felt flushed, heart racing. Had irregular rhythm. Transported to Emergency Department. Treated with epinephrine. EKG performed, having pre-ventricular contractions. Checked in to ED for further evaluation.


Changed on 12/24/2020

VAERS ID: 903112 Before After
VAERS Form:2
Age:44.0
Sex:Female
Location:Arkansas
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Electrocardiogram abnormal, Flushing, Heart rate irregular, Palpitations, Ventricular extrasystoles

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: solifenacin, fluticasone, loratadine
Current Illness:
Preexisting Conditions:
Allergies: codeine codeine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient felt flushed, heart racing. Had irregular rhythm. Transported to Emergency Department. Treated with epinephrine. EKG performed, having pre-ventricular contractions. Checked in to ED for further evaluation.


Changed on 12/30/2020

VAERS ID: 903112 Before After
VAERS Form:2
Age:44.0
Sex:Female
Location:Arkansas
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Electrocardiogram abnormal, Flushing, Heart rate irregular, Palpitations, Ventricular extrasystoles

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: solifenacin, fluticasone, loratadine
Current Illness:
Preexisting Conditions:
Allergies: codeine codeine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient felt flushed, heart racing. Had irregular rhythm. Transported to Emergency Department. Treated with epinephrine. EKG performed, having pre-ventricular contractions. Checked in to ED for further evaluation.


Changed on 5/7/2021

VAERS ID: 903112 Before After
VAERS Form:2
Age:44.0
Sex:Female
Location:Arkansas
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Electrocardiogram abnormal, Flushing, Heart rate irregular, Palpitations, Ventricular extrasystoles

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: solifenacin, fluticasone, loratadine
Current Illness:
Preexisting Conditions:
Allergies: codeine codeine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient felt flushed, heart racing. Had irregular rhythm. Transported to Emergency Department. Treated with epinephrine. EKG performed, having pre-ventricular contractions. Checked in to ED for further evaluation.


Changed on 5/21/2021

VAERS ID: 903112 Before After
VAERS Form:2
Age:44.0
Sex:Female
Location:Arkansas
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Electrocardiogram abnormal, Flushing, Heart rate irregular, Palpitations, Ventricular extrasystoles

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: solifenacin, fluticasone, loratadine
Current Illness:
Preexisting Conditions:
Allergies: codeine codeine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient felt flushed, heart racing. Had irregular rhythm. Transported to Emergency Department. Treated with epinephrine. EKG performed, having pre-ventricular contractions. Checked in to ED for further evaluation.

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