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This is VAERS ID 903839

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 903839
VAERS Form:2
Age:19.0
Sex:Female
Location:Alaska
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 EJ1685 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Erythema, Tachycardia

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: Synthroid
Current Illness: Group A strep on 11/30/2020
Preexisting Conditions: Hypothyroid Eczema
Allergies: NKA
Diagnostic Lab Data: monitored vital signs
CDC 'Split Type':

Write-up: Red neck and face 10min after injection lasting 15-20min Short episode of self resolving tachycardia


Changed on 12/30/2020

VAERS ID: 903839 Before After
VAERS Form:2
Age:19.0
Sex:Female
Location:Alaska
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 EJ1685 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Erythema, Tachycardia

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: Synthroid
Current Illness: Group A strep on 11/30/2020
Preexisting Conditions: Hypothyroid Eczema
Allergies: NKA NKA
Diagnostic Lab Data: monitored vital signs
CDC 'Split Type':

Write-up: Red neck and face 10min after injection lasting 15-20min Short episode of self resolving tachycardia


Changed on 5/7/2021

VAERS ID: 903839 Before After
VAERS Form:2
Age:19.0
Sex:Female
Location:Alaska
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 EJ1685 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Erythema, Tachycardia

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: Synthroid
Current Illness: Group A strep on 11/30/2020
Preexisting Conditions: Hypothyroid Eczema
Allergies: NKA NKA
Diagnostic Lab Data: monitored vital signs
CDC 'Split Type':

Write-up: Red neck and face 10min after injection lasting 15-20min Short episode of self resolving tachycardia


Changed on 5/14/2021

VAERS ID: 903839 Before After
VAERS Form:2
Age:19.0
Sex:Female
Location:Alaska
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 EJ1685 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Erythema, Tachycardia

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: Synthroid
Current Illness: Group A strep on 11/30/2020
Preexisting Conditions: Hypothyroid Eczema
Allergies: NKA NKA
Diagnostic Lab Data: monitored vital signs
CDC 'Split Type':

Write-up: Red neck and face 10min after injection lasting 15-20min Short episode of self resolving tachycardia

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=903839&WAYBACKHISTORY=ON

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