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This is VAERS ID 904072

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 904072
VAERS Form:2
Age:34.0
Sex:Female
Location:New York
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Dyspnoea

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: allegra Klonopin Lamictal Latuda Implanon PRILOSEC Synthroid albuterol inhaler
Current Illness:
Preexisting Conditions: Asthma gerd hypothyroid gastric sleeve GI bleed
Allergies: Latex, eggs, pork, shellfish, beef, cinamon
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Chest Tightness and shortness of breath


Changed on 12/30/2020

VAERS ID: 904072 Before After
VAERS Form:2
Age:34.0
Sex:Female
Location:New York
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Dyspnoea

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: allegra Klonopin Lamictal Latuda Implanon PRILOSEC Synthroid albuterol inhaler
Current Illness:
Preexisting Conditions: Asthma gerd hypothyroid gastric sleeve GI bleed
Allergies: Latex, eggs, pork, shellfish, beef, cinamon cinamon
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Chest Tightness and shortness of breath


Changed on 5/7/2021

VAERS ID: 904072 Before After
VAERS Form:2
Age:34.0
Sex:Female
Location:New York
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Dyspnoea

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: allegra Klonopin Lamictal Latuda Implanon PRILOSEC Synthroid albuterol inhaler
Current Illness:
Preexisting Conditions: Asthma gerd hypothyroid gastric sleeve GI bleed
Allergies: Latex, eggs, pork, shellfish, beef, cinamon cinamon
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Chest Tightness and shortness of breath


Changed on 5/14/2021

VAERS ID: 904072 Before After
VAERS Form:2
Age:34.0
Sex:Female
Location:New York
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Dyspnoea

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: allegra Klonopin Lamictal Latuda Implanon PRILOSEC Synthroid albuterol inhaler
Current Illness:
Preexisting Conditions: Asthma gerd hypothyroid gastric sleeve GI bleed
Allergies: Latex, eggs, pork, shellfish, beef, cinamon cinamon
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Chest Tightness and shortness of breath

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=904072&WAYBACKHISTORY=ON


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