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This is VAERS ID 903123

History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 903123
VAERS Form:2
Age:37.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-16
Onset:2020-12-16
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: Private      Purchased by: ??
Symptoms: Activated partial thromboplastin time shortened, Alanine aminotransferase normal, Anion gap, Aspartate aminotransferase normal, Basophil count normal, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood magnesium normal, Blood osmolarity decreased, Blood potassium decreased, Blood sodium normal, Blood urea normal, C-reactive protein increased, Carbon dioxide normal, Chest discomfort, Dizziness, Dyspnoea, Eosinophil count normal, Fibrin D dimer, Glomerular filtration rate decreased, Haematocrit normal, Haemoglobin normal, Injection site pain, International normalised ratio normal, Lymphocyte count normal, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin normal, Mean cell volume normal, Monocyte count normal, Neutrophil count normal, Palpitations, Platelet count normal, Protein total normal, Prothrombin time shortened, Rash, Rash erythematous, Red blood cell count normal, White blood cell count normal, Red blood cell sedimentation rate increased, Basophil percentage decreased, Eosinophil percentage decreased, Red cell distribution width normal, Mean platelet volume increased, Neutrophil percentage, Monocyte percentage, Blood urea nitrogen/creatinine ratio, Lymphocyte percentage, N-terminal prohormone brain natriuretic peptide normal, Troponin T normal, Immature granulocyte count increased, SARS-CoV-2 test negative

Life Threatening? Yes
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: Eliquis, Bumetanide
Current Illness: none
Preexisting Conditions: Pulmonary Hypertension Obesity Li-Fraumeni Syndrome H/o Breast Cancer
Allergies: Latex, Propofol, Nickel, Almonds
Diagnostic Lab Data: WBC 9.88 HGB 14.4 HCT 40.8 Platelet Count 292 RBC 4.81 MCV 84.8 MCH 29.9 MCHC 29.9 RDW 12.5 MPV 10.8 Sedimentation Rate 37 Diff Absolute Neutrophils 6.44 Absolute Imm. Granulocyte 0.01 Absolute Lymphocytes - CBC 2.94 Absolute Monocytes - 0.38 Absolute Eosinophils - 0.08 Absolute Basophils - 0.03 Neutrophils 65.2 % Immature Granulocyte 0.1% Lymphocytes 29.8% Monocytes 3.8% Eosinophils 0.8% Basophils 0.3% Coagulation Prothrombin Time 9.8 sec INR 1.0 Partial Thromboplastin Time 26.4 sec D-DIMER,QUANT 0.67mg/L ROUTINE CHEMISTRY NT-proBNP 29 BUN/Creatinine Ratio 11.4 Osmolality Calculated 277 GFR (estimated) 67 Sodium 139 Potassium 3.0 Chloride 98 CO2 30 BUN 10.7 Creatinine 0.94 Glucose Level 100 Calcium 9.5 Magnesium 1.9 Protein,Total 7.4 Albumin 4.5 AST (SGOT) 18 ALT (SGPT) 24 Alkaline Phosphatase 94 Bilirubin, Total 0.8 CRP, High-Sensitivity 1.72 Anion Gap 14 CARDIAC ISOENZYMES Troponin T <0.01 Molecular Diagnostics SARS-CoV-2 - negatieve
CDC 'Split Type':

Write-up: About 5 minutes after the vaccine developed chest tightness, increased work of breathing, palpitations and severe dizzyness. Transferred to the ED where i received oxygen, IV benadryl, IV fluids and monitoring. Released after about 4 hours and continue to take benadryl 50 mg PO q 4 hours. Also developed red facial rash (unknown time) Pain at injection site began the morning after the injection.


Changed on 12/24/2020

VAERS ID: 903123 Before After
VAERS Form:2
Age:37.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-16
Onset:2020-12-16
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: Private      Purchased by: ??
Symptoms: Activated partial thromboplastin time shortened, Alanine aminotransferase normal, Anion gap, Aspartate aminotransferase normal, Basophil count normal, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood magnesium normal, Blood osmolarity decreased, Blood potassium decreased, Blood sodium normal, Blood urea normal, C-reactive protein increased, Carbon dioxide normal, Chest discomfort, Dizziness, Dyspnoea, Eosinophil count normal, Fibrin D dimer, Glomerular filtration rate decreased, Haematocrit normal, Haemoglobin normal, Injection site pain, International normalised ratio normal, Lymphocyte count normal, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin normal, Mean cell volume normal, Monocyte count normal, Neutrophil count normal, Palpitations, Platelet count normal, Protein total normal, Prothrombin time shortened, Rash, Rash erythematous, Red blood cell count normal, White blood cell count normal, Red blood cell sedimentation rate increased, Basophil percentage decreased, Eosinophil percentage decreased, Red cell distribution width normal, Mean platelet volume increased, Neutrophil percentage, Monocyte percentage, Blood urea nitrogen/creatinine ratio, Lymphocyte percentage, N-terminal prohormone brain natriuretic peptide normal, Troponin T normal, Immature granulocyte count increased, SARS-CoV-2 test negative

Life Threatening? Yes
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: Eliquis, Bumetanide
Current Illness: none
Preexisting Conditions: Pulmonary Hypertension Obesity Li-Fraumeni Syndrome H/o Breast Cancer
Allergies: Latex, Propofol, Nickel, Almonds Almonds
Diagnostic Lab Data: WBC 9.88 HGB 14.4 HCT 40.8 Platelet Count 292 RBC 4.81 MCV 84.8 MCH 29.9 MCHC 29.9 RDW 12.5 MPV 10.8 Sedimentation Rate 37 Diff Absolute Neutrophils 6.44 Absolute Imm. Granulocyte 0.01 Absolute Lymphocytes - CBC 2.94 Absolute Monocytes - 0.38 Absolute Eosinophils - 0.08 Absolute Basophils - 0.03 Neutrophils 65.2 % Immature Granulocyte 0.1% Lymphocytes 29.8% Monocytes 3.8% Eosinophils 0.8% Basophils 0.3% Coagulation Prothrombin Time 9.8 sec INR 1.0 Partial Thromboplastin Time 26.4 sec D-DIMER,QUANT 0.67mg/L ROUTINE CHEMISTRY NT-proBNP 29 BUN/Creatinine Ratio 11.4 Osmolality Calculated 277 GFR (estimated) 67 Sodium 139 Potassium 3.0 Chloride 98 CO2 30 BUN 10.7 Creatinine 0.94 Glucose Level 100 Calcium 9.5 Magnesium 1.9 Protein,Total 7.4 Albumin 4.5 AST (SGOT) 18 ALT (SGPT) 24 Alkaline Phosphatase 94 Bilirubin, Total 0.8 CRP, High-Sensitivity 1.72 Anion Gap 14 CARDIAC ISOENZYMES Troponin T <0.01 Molecular Diagnostics SARS-CoV-2 - negatieve
CDC 'Split Type':

Write-up: About 5 minutes after the vaccine developed chest tightness, increased work of breathing, palpitations and severe dizzyness. Transferred to the ED where i received oxygen, IV benadryl, IV fluids and monitoring. Released after about 4 hours and continue to take benadryl 50 mg PO q 4 hours. Also developed red facial rash (unknown time) Pain at injection site began the morning after the injection.


Changed on 12/30/2020

VAERS ID: 903123 Before After
VAERS Form:2
Age:37.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-16
Onset:2020-12-16
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: Private      Purchased by: ??
Symptoms: Activated partial thromboplastin time shortened, Alanine aminotransferase normal, Anion gap, Aspartate aminotransferase normal, Basophil count normal, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood glucose normal, Blood magnesium normal, Blood osmolarity decreased, Blood potassium decreased, Blood sodium normal, Blood urea normal, C-reactive protein increased, Chest discomfort, Dizziness, Dyspnoea, Eosinophil count normal, Fibrin D dimer, Glomerular filtration rate decreased, Haematocrit normal, Haemoglobin normal, Injection site pain, International normalised ratio normal, Lymphocyte count normal, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin normal, Mean cell volume normal, Monocyte count normal, Neutrophil count normal, Palpitations, Platelet count normal, Protein total normal, Rash, Rash erythematous, Red blood cell count normal, White blood cell count normal, Red blood cell sedimentation rate increased, Basophil percentage decreased, Eosinophil percentage decreased, Red cell distribution width normal, Mean platelet volume increased, Neutrophil percentage, Monocyte percentage, Blood urea nitrogen/creatinine ratio, Lymphocyte percentage, N-terminal prohormone brain natriuretic peptide normal, Troponin T normal, Immature granulocyte count increased, SARS-CoV-2 test negative

Life Threatening? Yes
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: Eliquis, Bumetanide
Current Illness: none
Preexisting Conditions: Pulmonary Hypertension Obesity Li-Fraumeni Syndrome H/o Breast Cancer
Allergies: Latex, Propofol, Nickel, Almonds Almonds
Diagnostic Lab Data: WBC 9.88 HGB 14.4 HCT 40.8 Platelet Count 292 RBC 4.81 MCV 84.8 MCH 29.9 MCHC 29.9 RDW 12.5 MPV 10.8 Sedimentation Rate 37 Diff Absolute Neutrophils 6.44 Absolute Imm. Granulocyte 0.01 Absolute Lymphocytes - CBC 2.94 Absolute Monocytes - 0.38 Absolute Eosinophils - 0.08 Absolute Basophils - 0.03 Neutrophils 65.2 % Immature Granulocyte 0.1% Lymphocytes 29.8% Monocytes 3.8% Eosinophils 0.8% Basophils 0.3% Coagulation Prothrombin Time 9.8 sec INR 1.0 Partial Thromboplastin Time 26.4 sec D-DIMER,QUANT 0.67mg/L ROUTINE CHEMISTRY NT-proBNP 29 BUN/Creatinine Ratio 11.4 Osmolality Calculated 277 GFR (estimated) 67 Sodium 139 Potassium 3.0 Chloride 98 CO2 30 BUN 10.7 Creatinine 0.94 Glucose Level 100 Calcium 9.5 Magnesium 1.9 Protein,Total 7.4 Albumin 4.5 AST (SGOT) 18 ALT (SGPT) 24 Alkaline Phosphatase 94 Bilirubin, Total 0.8 CRP, High-Sensitivity 1.72 Anion Gap 14 CARDIAC ISOENZYMES Troponin T <0.01 Molecular Diagnostics SARS-CoV-2 - negatieve
CDC 'Split Type':

Write-up: About 5 minutes after the vaccine developed chest tightness, increased work of breathing, palpitations and severe dizzyness. Transferred to the ED where i received oxygen, IV benadryl, IV fluids and monitoring. Released after about 4 hours and continue to take benadryl 50 mg PO q 4 hours. Also developed red facial rash (unknown time) Pain at injection site began the morning after the injection.

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