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This is VAERS ID 903766

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 903766
VAERS Form:2
Age:36.0
Sex:Female
Location:Arizona
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: Private      Purchased by: ??
Symptoms: Angioedema, Full blood count, Metabolic function test, Human chorionic gonadotropin

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxine 100 mcg, albuterol HFA, Wellbutrin XL
Current Illness: None
Preexisting Conditions: CSF leak, migraines, asthma
Allergies: Amoxicillin (hives), divalproex (swelling)
Diagnostic Lab Data: CBC, BMP, HCG
CDC 'Split Type':

Write-up: Angioedema


Changed on 12/30/2020

VAERS ID: 903766 Before After
VAERS Form:2
Age:36.0
Sex:Female
Location:Arizona
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: Private      Purchased by: ??
Symptoms: Angioedema, Full blood count, Metabolic function test, Human chorionic gonadotropin

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxine 100 mcg, albuterol HFA, Wellbutrin XL
Current Illness: None
Preexisting Conditions: CSF leak, migraines, asthma
Allergies: Amoxicillin (hives), divalproex (swelling) (swelling)
Diagnostic Lab Data: CBC, BMP, HCG
CDC 'Split Type':

Write-up: Angioedema


Changed on 5/7/2021

VAERS ID: 903766 Before After
VAERS Form:2
Age:36.0
Sex:Female
Location:Arizona
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: Private      Purchased by: ??
Symptoms: Angioedema, Full blood count, Metabolic function test, Human chorionic gonadotropin

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxine 100 mcg, albuterol HFA, Wellbutrin XL
Current Illness: None
Preexisting Conditions: CSF leak, migraines, asthma
Allergies: Amoxicillin (hives), divalproex (swelling) (swelling)
Diagnostic Lab Data: CBC, BMP, HCG
CDC 'Split Type':

Write-up: Angioedema


Changed on 5/14/2021

VAERS ID: 903766 Before After
VAERS Form:2
Age:36.0
Sex:Female
Location:Arizona
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: Private      Purchased by: ??
Symptoms: Angioedema, Full blood count, Metabolic function test, Human chorionic gonadotropin

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxine 100 mcg, albuterol HFA, Wellbutrin XL
Current Illness: None
Preexisting Conditions: CSF leak, migraines, asthma
Allergies: Amoxicillin (hives), divalproex (swelling) (swelling)
Diagnostic Lab Data: CBC, BMP, HCG
CDC 'Split Type':

Write-up: Angioedema

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