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This is VAERS ID 903210

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 903210
VAERS Form:2
Age:27.0
Sex:Female
Location:Oklahoma
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: Private      Purchased by: ??
Symptoms: Flushing, Pruritus

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: History of anaphylaxis and rash from band aid with flu vaccination
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: History of anaphylaxis with latex
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Patient reported feeling fine for the first 15 minutes after the vaccination was given then reported itching of her face excluding her forehead. Patient was given 25mg IM diphenhydramine. Pulse ox was taken and read within normal limits. Within 5-10 minutes after the diphenhydramine was given patient reported itching involving her arms, facial flushing but no shortness of breath. An extra dose of 25mg IM diphenhydramine was given and an IM EpiPen.


Changed on 12/24/2020

VAERS ID: 903210 Before After
VAERS Form:2
Age:27.0
Sex:Female
Location:Oklahoma
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: Private      Purchased by: ??
Symptoms: Flushing, Pruritus

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: History of anaphylaxis and rash from band aid with flu vaccination
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: History of anaphylaxis with latex latex
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Patient reported feeling fine for the first 15 minutes after the vaccination was given then reported itching of her face excluding her forehead. Patient was given 25mg IM diphenhydramine. Pulse ox was taken and read within normal limits. Within 5-10 minutes after the diphenhydramine was given patient reported itching involving her arms, facial flushing but no shortness of breath. An extra dose of 25mg IM diphenhydramine was given and an IM EpiPen.


Changed on 12/30/2020

VAERS ID: 903210 Before After
VAERS Form:2
Age:27.0
Sex:Female
Location:Oklahoma
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: Private      Purchased by: ??
Symptoms: Flushing, Pruritus

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: History of anaphylaxis and rash from band aid with flu vaccination
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: History of anaphylaxis with latex latex
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Patient reported feeling fine for the first 15 minutes after the vaccination was given then reported itching of her face excluding her forehead. Patient was given 25mg IM diphenhydramine. Pulse ox was taken and read within normal limits. Within 5-10 minutes after the diphenhydramine was given patient reported itching involving her arms, facial flushing but no shortness of breath. An extra dose of 25mg IM diphenhydramine was given and an IM EpiPen.


Changed on 5/7/2021

VAERS ID: 903210 Before After
VAERS Form:2
Age:27.0
Sex:Female
Location:Oklahoma
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: Private      Purchased by: ??
Symptoms: Flushing, Pruritus

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: History of anaphylaxis and rash from band aid with flu vaccination
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: History of anaphylaxis with latex latex
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Patient reported feeling fine for the first 15 minutes after the vaccination was given then reported itching of her face excluding her forehead. Patient was given 25mg IM diphenhydramine. Pulse ox was taken and read within normal limits. Within 5-10 minutes after the diphenhydramine was given patient reported itching involving her arms, facial flushing but no shortness of breath. An extra dose of 25mg IM diphenhydramine was given and an IM EpiPen.


Changed on 5/14/2021

VAERS ID: 903210 Before After
VAERS Form:2
Age:27.0
Sex:Female
Location:Oklahoma
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: Private      Purchased by: ??
Symptoms: Flushing, Pruritus

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: History of anaphylaxis and rash from band aid with flu vaccination
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: History of anaphylaxis with latex latex
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Patient reported feeling fine for the first 15 minutes after the vaccination was given then reported itching of her face excluding her forehead. Patient was given 25mg IM diphenhydramine. Pulse ox was taken and read within normal limits. Within 5-10 minutes after the diphenhydramine was given patient reported itching involving her arms, facial flushing but no shortness of breath. An extra dose of 25mg IM diphenhydramine was given and an IM EpiPen.

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