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This is VAERS ID 904234

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 904234
VAERS Form:2
Age:44.0
Sex:Female
Location:Illinois
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 - / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dyspnoea, Palpitations, Rash, Tachycardia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imitrex, Topamax
Current Illness:
Preexisting Conditions: migraines
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Rach, tachycardia, palpitations, shortness of breath shortly after receiving vaccine - given epi, solumedrol, Benadryl. persistent symptoms the following day.


Changed on 12/30/2020

VAERS ID: 904234 Before After
VAERS Form:2
Age:44.0
Sex:Female
Location:Illinois
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 - / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dyspnoea, Palpitations, Rash, Tachycardia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imitrex, Topamax
Current Illness:
Preexisting Conditions: migraines
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Rach, tachycardia, palpitations, shortness of breath shortly after receiving vaccine - given epi, solumedrol, Benadryl. persistent symptoms the following day.


Changed on 5/7/2021

VAERS ID: 904234 Before After
VAERS Form:2
Age:44.0
Sex:Female
Location:Illinois
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 - / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dyspnoea, Palpitations, Rash, Tachycardia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imitrex, Topamax
Current Illness:
Preexisting Conditions: migraines
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Rach, tachycardia, palpitations, shortness of breath shortly after receiving vaccine - given epi, solumedrol, Benadryl. persistent symptoms the following day.


Changed on 5/14/2021

VAERS ID: 904234 Before After
VAERS Form:2
Age:44.0
Sex:Female
Location:Illinois
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 - / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dyspnoea, Palpitations, Rash, Tachycardia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imitrex, Topamax
Current Illness:
Preexisting Conditions: migraines
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Rach, tachycardia, palpitations, shortness of breath shortly after receiving vaccine - given epi, solumedrol, Benadryl. persistent symptoms the following day.

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