National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 904199

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 904199
VAERS Form:2
Age:18.0
Sex:Female
Location:South Dakota
Vaccinated:2020-12-19
Onset:2020-12-19
Submitted:0000-00-00
Entered:2020-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH BEH9899 / 1 UN / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Lip swelling, Throat irritation, Hypoaesthesia oral

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ventolin inhaler EpiPen Fluoxetine Flonase Trazodone
Current Illness: None
Preexisting Conditions: Depression, Obesity, Anxiety
Allergies: Bee stings
Diagnostic Lab Data: Epinephrine IM, Pepcid, Benadryl, Prednisone, Acetaminophen, Toradol - for pain from Epi injection site
CDC 'Split Type':

Write-up: Scratchy throat, lip swelling and numbness


Changed on 12/30/2020

VAERS ID: 904199 Before After
VAERS Form:2
Age:18.0
Sex:Female
Location:South Dakota
Vaccinated:2020-12-19
Onset:2020-12-19
Submitted:0000-00-00
Entered:2020-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH BEH9899 / 1 UN / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Lip swelling, Throat irritation, Hypoaesthesia oral

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ventolin inhaler EpiPen Fluoxetine Flonase Trazodone
Current Illness: None
Preexisting Conditions: Depression, Obesity, Anxiety
Allergies: Bee stings stings
Diagnostic Lab Data: Epinephrine IM, Pepcid, Benadryl, Prednisone, Acetaminophen, Toradol - for pain from Epi injection site
CDC 'Split Type':

Write-up: Scratchy throat, lip swelling and numbness


Changed on 5/7/2021

VAERS ID: 904199 Before After
VAERS Form:2
Age:18.0
Sex:Female
Location:South Dakota
Vaccinated:2020-12-19
Onset:2020-12-19
Submitted:0000-00-00
Entered:2020-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH BEH9899 / 1 UN / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Lip swelling, Throat irritation, Hypoaesthesia oral

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ventolin inhaler EpiPen Fluoxetine Flonase Trazodone
Current Illness: None
Preexisting Conditions: Depression, Obesity, Anxiety
Allergies: Bee stings stings
Diagnostic Lab Data: Epinephrine IM, Pepcid, Benadryl, Prednisone, Acetaminophen, Toradol - for pain from Epi injection site
CDC 'Split Type':

Write-up: Scratchy throat, lip swelling and numbness


Changed on 5/14/2021

VAERS ID: 904199 Before After
VAERS Form:2
Age:18.0
Sex:Female
Location:South Dakota
Vaccinated:2020-12-19
Onset:2020-12-19
Submitted:0000-00-00
Entered:2020-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH BEH9899 / 1 UN / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Lip swelling, Throat irritation, Hypoaesthesia oral

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ventolin inhaler EpiPen Fluoxetine Flonase Trazodone
Current Illness: None
Preexisting Conditions: Depression, Obesity, Anxiety
Allergies: Bee stings stings
Diagnostic Lab Data: Epinephrine IM, Pepcid, Benadryl, Prednisone, Acetaminophen, Toradol - for pain from Epi injection site
CDC 'Split Type':

Write-up: Scratchy throat, lip swelling and numbness

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=904199&WAYBACKHISTORY=ON

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166