National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 903540

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 903540
VAERS Form:2
Age:49.0
Sex:Female
Location:Alabama
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Pallor, Pruritus, Tremor, Vomiting

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: None noted
Preexisting Conditions: Unknown
Allergies: unknown to food, allergy to metoclopramide
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: After the patient received Covid vaccine, she started experiencing itching. The nurse monitoring the patient noticed she was scratching. The patient continued to itch during the 15 minute observations period but no other adverse effects were noticed. The observation period was extended to 30 minutes and then the patient was released. An hour after she left the vaccination site she experienced an episode of vomiting which resolved. Her husband noticed her to be pale upon returning home. Later that night the patient was visibly shaking and had another episode of vomiting. All symptoms have since resolved.


Changed on 12/30/2020

VAERS ID: 903540 Before After
VAERS Form:2
Age:49.0
Sex:Female
Location:Alabama
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Pallor, Pruritus, Tremor, Vomiting

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: None noted
Preexisting Conditions: Unknown
Allergies: unknown to food, allergy to metoclopramide metoclopramide
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: After the patient received Covid vaccine, she started experiencing itching. The nurse monitoring the patient noticed she was scratching. The patient continued to itch during the 15 minute observations period but no other adverse effects were noticed. The observation period was extended to 30 minutes and then the patient was released. An hour after she left the vaccination site she experienced an episode of vomiting which resolved. Her husband noticed her to be pale upon returning home. Later that night the patient was visibly shaking and had another episode of vomiting. All symptoms have since resolved.


Changed on 5/7/2021

VAERS ID: 903540 Before After
VAERS Form:2
Age:49.0
Sex:Female
Location:Alabama
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Pallor, Pruritus, Tremor, Vomiting

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: None noted
Preexisting Conditions: Unknown
Allergies: unknown to food, allergy to metoclopramide metoclopramide
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: After the patient received Covid vaccine, she started experiencing itching. The nurse monitoring the patient noticed she was scratching. The patient continued to itch during the 15 minute observations period but no other adverse effects were noticed. The observation period was extended to 30 minutes and then the patient was released. An hour after she left the vaccination site she experienced an episode of vomiting which resolved. Her husband noticed her to be pale upon returning home. Later that night the patient was visibly shaking and had another episode of vomiting. All symptoms have since resolved.


Changed on 5/21/2021

VAERS ID: 903540 Before After
VAERS Form:2
Age:49.0
Sex:Female
Location:Alabama
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Pallor, Pruritus, Tremor, Vomiting

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: None noted
Preexisting Conditions: Unknown
Allergies: unknown to food, allergy to metoclopramide metoclopramide
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: After the patient received Covid vaccine, she started experiencing itching. The nurse monitoring the patient noticed she was scratching. The patient continued to itch during the 15 minute observations period but no other adverse effects were noticed. The observation period was extended to 30 minutes and then the patient was released. An hour after she left the vaccination site she experienced an episode of vomiting which resolved. Her husband noticed her to be pale upon returning home. Later that night the patient was visibly shaking and had another episode of vomiting. All symptoms have since resolved.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=903540&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166