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This is VAERS ID 907173

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 907173
VAERS Form:2
Age:52.0
Sex:Female
Location:North Carolina
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Stridor, Urticaria, Wheezing, Respiratory tract oedema

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair, Tylenol, Flexeril, Zyrtec, Norco, Singulair, Janumet, Turmeric, vitamin A
Current Illness:
Preexisting Conditions: Obesity, asthma
Allergies: Metoprolol, Biaxin, Lopressors, Robaxin,
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Anaphylaxis reaction with hives, stridor/airway edema, wheezing


Changed on 5/7/2021

VAERS ID: 907173 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:North Carolina
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Stridor, Urticaria, Wheezing, Respiratory tract oedema

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair, Tylenol, Flexeril, Zyrtec, Norco, Singulair, Janumet, Turmeric, vitamin A
Current Illness:
Preexisting Conditions: Obesity, asthma
Allergies: Metoprolol, Biaxin, Lopressors, Robaxin, Robaxin,
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Anaphylaxis reaction with hives, stridor/airway edema, wheezing


Changed on 5/14/2021

VAERS ID: 907173 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:North Carolina
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Stridor, Urticaria, Wheezing, Respiratory tract oedema

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair, Tylenol, Flexeril, Zyrtec, Norco, Singulair, Janumet, Turmeric, vitamin A
Current Illness:
Preexisting Conditions: Obesity, asthma
Allergies: Metoprolol, Biaxin, Lopressors, Robaxin, Robaxin,
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Anaphylaxis reaction with hives, stridor/airway edema, wheezing

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=907173&WAYBACKHISTORY=ON


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