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This is VAERS ID 903806

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 903806
VAERS Form:2
Age:89.0
Sex:Female
Location:Florida
Vaccinated:2020-12-17
Onset:2020-12-18
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: Dyspnoea, SARS-CoV-2 test positive

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lorazepam, Depakote, Trazadone, Coreg, Bumetanide, Senna, Bumetanide
Current Illness: Mild cough
Preexisting Conditions: A fib, Gastro reflux, type 2 diabetes, hypertension, edema, anxiety, heart failure, pacemaker, obesity, OA, anemia
Allergies: Codeine, morphine, propafenone
Diagnostic Lab Data: Tests performed at hospital
CDC 'Split Type':

Write-up: Resident became short of breath 7 hours after vaccine, went to hospital, was COVID+


Changed on 12/30/2020

VAERS ID: 903806 Before After
VAERS Form:2
Age:89.0
Sex:Female
Location:Florida
Vaccinated:2020-12-17
Onset:2020-12-18
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: Dyspnoea, SARS-CoV-2 test positive

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)? Yes No
Hospitalized? No Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lorazepam, Depakote, Trazadone, Coreg, Bumetanide, Senna, Bumetanide
Current Illness: Mild cough
Preexisting Conditions: A fib, Gastro reflux, type 2 diabetes, hypertension, edema, anxiety, heart failure, pacemaker, obesity, OA, anemia
Allergies: Codeine, morphine, propafenone propafenone
Diagnostic Lab Data: Tests performed at hospital
CDC 'Split Type':

Write-up: Resident became short of breath 7 hours after vaccine, went to hospital, was COVID+


Changed on 5/7/2021

VAERS ID: 903806 Before After
VAERS Form:2
Age:89.0
Sex:Female
Location:Florida
Vaccinated:2020-12-17
Onset:2020-12-18
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: Dyspnoea, SARS-CoV-2 test positive

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lorazepam, Depakote, Trazadone, Coreg, Bumetanide, Senna, Bumetanide
Current Illness: Mild cough
Preexisting Conditions: A fib, Gastro reflux, type 2 diabetes, hypertension, edema, anxiety, heart failure, pacemaker, obesity, OA, anemia
Allergies: Codeine, morphine, propafenone propafenone
Diagnostic Lab Data: Tests performed at hospital
CDC 'Split Type':

Write-up: Resident became short of breath 7 hours after vaccine, went to hospital, was COVID+


Changed on 5/14/2021

VAERS ID: 903806 Before After
VAERS Form:2
Age:89.0
Sex:Female
Location:Florida
Vaccinated:2020-12-17
Onset:2020-12-18
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: Dyspnoea, SARS-CoV-2 test positive

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lorazepam, Depakote, Trazadone, Coreg, Bumetanide, Senna, Bumetanide
Current Illness: Mild cough
Preexisting Conditions: A fib, Gastro reflux, type 2 diabetes, hypertension, edema, anxiety, heart failure, pacemaker, obesity, OA, anemia
Allergies: Codeine, morphine, propafenone propafenone
Diagnostic Lab Data: Tests performed at hospital
CDC 'Split Type':

Write-up: Resident became short of breath 7 hours after vaccine, went to hospital, was COVID+

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