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This is VAERS ID 903591

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 903591
VAERS Form:2
Age:41.0
Sex:Female
Location:West Virginia
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 EH9899 / UNK RA / IM

Administered by: Work      Purchased by: ??
Symptoms: Chills, Feeling jittery, Lacrimation increased, Malaise, Ocular hyperaemia, Pain, Photophobia, Vision blurred

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benicar. Allegra. Estrogen Hormone Cream
Current Illness: COVID 19 November 2020
Preexisting Conditions: HTN. Asthma. Interstitial cystitis. Gastritis
Allergies: Norco. Tofranil. Danocrine
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Patient reports 1 hour post vaccination symptoms: jittery, feeling lousy. 12/18/20 Am reported bodyaches, red/watery eyes, chills, and blurred vision. States she can see better in dark than in bright lights. Previously hx of COVID 19 illness November 2020. Took Tylenol and Allegra 12/18/20. Reports improvement in symptoms 12/18/20 12:40pm but continues to report mild blurred vision. Advised to seek immediate medical care if condition not improved or worsens.


Changed on 12/30/2020

VAERS ID: 903591 Before After
VAERS Form:2
Age:41.0
Sex:Female
Location:West Virginia
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 EH9899 / UNK RA / IM

Administered by: Work      Purchased by: ??
Symptoms: Chills, Feeling jittery, Lacrimation increased, Malaise, Ocular hyperaemia, Pain, Photophobia, Vision blurred

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benicar. Allegra. Estrogen Hormone Cream
Current Illness: COVID 19 November 2020
Preexisting Conditions: HTN. Asthma. Interstitial cystitis. Gastritis
Allergies: Norco. Tofranil. Danocrine Danocrine
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Patient reports 1 hour post vaccination symptoms: jittery, feeling lousy. 12/18/20 Am reported bodyaches, red/watery eyes, chills, and blurred vision. States she can see better in dark than in bright lights. Previously hx of COVID 19 illness November 2020. Took Tylenol and Allegra 12/18/20. Reports improvement in symptoms 12/18/20 12:40pm but continues to report mild blurred vision. Advised to seek immediate medical care if condition not improved or worsens.


Changed on 5/7/2021

VAERS ID: 903591 Before After
VAERS Form:2
Age:41.0
Sex:Female
Location:West Virginia
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 EH9899 / UNK RA / IM

Administered by: Work      Purchased by: ??
Symptoms: Chills, Feeling jittery, Lacrimation increased, Malaise, Ocular hyperaemia, Pain, Photophobia, Vision blurred

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benicar. Allegra. Estrogen Hormone Cream
Current Illness: COVID 19 November 2020
Preexisting Conditions: HTN. Asthma. Interstitial cystitis. Gastritis
Allergies: Norco. Tofranil. Danocrine Danocrine
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Patient reports 1 hour post vaccination symptoms: jittery, feeling lousy. 12/18/20 Am reported bodyaches, red/watery eyes, chills, and blurred vision. States she can see better in dark than in bright lights. Previously hx of COVID 19 illness November 2020. Took Tylenol and Allegra 12/18/20. Reports improvement in symptoms 12/18/20 12:40pm but continues to report mild blurred vision. Advised to seek immediate medical care if condition not improved or worsens.


Changed on 5/21/2021

VAERS ID: 903591 Before After
VAERS Form:2
Age:41.0
Sex:Female
Location:West Virginia
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 EH9899 / UNK RA / IM

Administered by: Work      Purchased by: ??
Symptoms: Chills, Feeling jittery, Lacrimation increased, Malaise, Ocular hyperaemia, Pain, Photophobia, Vision blurred

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benicar. Allegra. Estrogen Hormone Cream
Current Illness: COVID 19 November 2020
Preexisting Conditions: HTN. Asthma. Interstitial cystitis. Gastritis
Allergies: Norco. Tofranil. Danocrine Danocrine
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Patient reports 1 hour post vaccination symptoms: jittery, feeling lousy. 12/18/20 Am reported bodyaches, red/watery eyes, chills, and blurred vision. States she can see better in dark than in bright lights. Previously hx of COVID 19 illness November 2020. Took Tylenol and Allegra 12/18/20. Reports improvement in symptoms 12/18/20 12:40pm but continues to report mild blurred vision. Advised to seek immediate medical care if condition not improved or worsens.

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