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This is VAERS ID 904349

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 904349
VAERS Form:2
Age:36.0
Sex:Female
Location:North Dakota
Vaccinated:2020-12-14
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Computerised tomogram, Nausea, Pancreatitis acute, Vomiting, Lipase

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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: singulair, albuterol, Adderall XR, Symbicort, clonidine, B12 supplement, omeprazole, fexofenadine, fluoxetine, Mirena, levothyroxine, lorazepam, oxcarbazepine, Phenergan, Vitamin D3
Current Illness:
Preexisting Conditions: Bipolar 1, Severe persistent Asthma, Morbid Obesity
Allergies:
Diagnostic Lab Data: lipase, CT scan
CDC 'Split Type':

Write-up: acute, mild pancreatitis, associated with symptoms associated with Nausea and vomiting and abdominal pain. Patient''s symptoms started 1 day after her vaccination.


Changed on 12/30/2020

VAERS ID: 904349 Before After
VAERS Form:2
Age:36.0
Sex:Female
Location:North Dakota
Vaccinated:2020-12-14
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Computerised tomogram, Nausea, Pancreatitis acute, Vomiting, Lipase

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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: singulair, albuterol, Adderall XR, Symbicort, clonidine, B12 supplement, omeprazole, fexofenadine, fluoxetine, Mirena, levothyroxine, lorazepam, oxcarbazepine, Phenergan, Vitamin D3
Current Illness:
Preexisting Conditions: Bipolar 1, Severe persistent Asthma, Morbid Obesity
Allergies:
Diagnostic Lab Data: lipase, CT scan
CDC 'Split Type':

Write-up: acute, mild pancreatitis, associated with symptoms associated with Nausea and vomiting and abdominal pain. Patient''s symptoms started 1 day after her vaccination.


Changed on 5/7/2021

VAERS ID: 904349 Before After
VAERS Form:2
Age:36.0
Sex:Female
Location:North Dakota
Vaccinated:2020-12-14
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Computerised tomogram, Nausea, Pancreatitis acute, Vomiting, Lipase

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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: singulair, albuterol, Adderall XR, Symbicort, clonidine, B12 supplement, omeprazole, fexofenadine, fluoxetine, Mirena, levothyroxine, lorazepam, oxcarbazepine, Phenergan, Vitamin D3
Current Illness:
Preexisting Conditions: Bipolar 1, Severe persistent Asthma, Morbid Obesity
Allergies:
Diagnostic Lab Data: lipase, CT scan
CDC 'Split Type':

Write-up: acute, mild pancreatitis, associated with symptoms associated with Nausea and vomiting and abdominal pain. Patient''s symptoms started 1 day after her vaccination.


Changed on 5/14/2021

VAERS ID: 904349 Before After
VAERS Form:2
Age:36.0
Sex:Female
Location:North Dakota
Vaccinated:2020-12-14
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Computerised tomogram, Nausea, Pancreatitis acute, Vomiting, Lipase

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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: singulair, albuterol, Adderall XR, Symbicort, clonidine, B12 supplement, omeprazole, fexofenadine, fluoxetine, Mirena, levothyroxine, lorazepam, oxcarbazepine, Phenergan, Vitamin D3
Current Illness:
Preexisting Conditions: Bipolar 1, Severe persistent Asthma, Morbid Obesity
Allergies:
Diagnostic Lab Data: lipase, CT scan
CDC 'Split Type':

Write-up: acute, mild pancreatitis, associated with symptoms associated with Nausea and vomiting and abdominal pain. Patient''s symptoms started 1 day after her vaccination.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=904349&WAYBACKHISTORY=ON


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