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This is VAERS ID 904398

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 904398
VAERS Form:2
Age:35.0
Sex:Female
Location:Washington
Vaccinated:2020-12-20
Onset:2020-12-20
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: Anaphylactoid reaction, Stridor, Oxygen therapy

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Anaphylaxis type reaction, stridor, treated with 02, epi pen, moved to hospitals ED


Changed on 5/7/2021

VAERS ID: 904398 Before After
VAERS Form:2
Age:35.0
Sex:Female
Location:Washington
Vaccinated:2020-12-20
Onset:2020-12-20
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: Anaphylactoid reaction, Stridor, Oxygen therapy

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Anaphylaxis type reaction, stridor, treated with 02, epi pen, moved to hospitals ED


Changed on 5/14/2021

VAERS ID: 904398 Before After
VAERS Form:2
Age:35.0
Sex:Female
Location:Washington
Vaccinated:2020-12-20
Onset:2020-12-20
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: Anaphylactoid reaction, Stridor, Oxygen therapy

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Anaphylaxis type reaction, stridor, treated with 02, epi pen, moved to hospitals ED

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=904398&WAYBACKHISTORY=ON

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