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This is VAERS ID 903389

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 903389
VAERS Form:2
Age:52.0
Sex:Female
Location:Florida
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Headache, Pruritus, 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:
Other Medications: Atorvastatin, glyburide, lisinopril, metformin, nitroglycerine, topiramate
Current Illness:
Preexisting Conditions:
Allergies: Fish, seafood, iodine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, pruritis, headache


Changed on 12/30/2020

VAERS ID: 903389 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Florida
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Headache, Pruritus, 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:
Other Medications: Atorvastatin, glyburide, lisinopril, metformin, nitroglycerine, topiramate
Current Illness:
Preexisting Conditions:
Allergies: Fish, seafood, iodine iodine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, pruritis, headache


Changed on 5/7/2021

VAERS ID: 903389 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Florida
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Headache, Pruritus, 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:
Other Medications: Atorvastatin, glyburide, lisinopril, metformin, nitroglycerine, topiramate
Current Illness:
Preexisting Conditions:
Allergies: Fish, seafood, iodine iodine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, pruritis, headache


Changed on 5/21/2021

VAERS ID: 903389 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Florida
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Headache, Pruritus, 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:
Other Medications: Atorvastatin, glyburide, lisinopril, metformin, nitroglycerine, topiramate
Current Illness:
Preexisting Conditions:
Allergies: Fish, seafood, iodine iodine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, pruritis, headache

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