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This is VAERS ID 907485

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 907485
VAERS Form:2
Age:47.0
Sex:Female
Location:California
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Electrocardiogram, Full blood count, Hypertension, Intensive care, Tachycardia, Pharyngeal swelling

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: azelastine 137 mcg (0.1 %) nasal spray Commonly known as: ASTELIN buPROPion XL 150 mg 24 hr tablet Commonly known as: WELLBUTRIN XL cholecalciferol 50 mcg (2,000 unit) tablet Commonly known as: VITAMIN D3 doxycycline hyclate 100 mg capsule
Current Illness: Obstructive sleep apnea hypopnea, mild Pre-diabetes Other migraine without status migrainosus, not intractable Dyslipidemia PMDD Obesity Kidney stones
Preexisting Conditions: Obesity Migraine PMDD
Allergies: Allergies Hydrocodone-acetaminophen Oxycodone-acetaminophen Sulfa (sulfonamide Antibiotics) Tramadol
Diagnostic Lab Data: CBC EKG
CDC 'Split Type':

Write-up: Anaphylactic with throat swelling , tachycardia and high BP. Pt was given steroids, epi pen, Benadryl and observed in ICU overnight.


Changed on 5/7/2021

VAERS ID: 907485 Before After
VAERS Form:2
Age:47.0
Sex:Female
Location:California
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Electrocardiogram, Full blood count, Hypertension, Intensive care, Tachycardia, Pharyngeal swelling

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: azelastine 137 mcg (0.1 %) nasal spray Commonly known as: ASTELIN buPROPion XL 150 mg 24 hr tablet Commonly known as: WELLBUTRIN XL cholecalciferol 50 mcg (2,000 unit) tablet Commonly known as: VITAMIN D3 doxycycline hyclate 100 mg capsule
Current Illness: Obstructive sleep apnea hypopnea, mild Pre-diabetes Other migraine without status migrainosus, not intractable Dyslipidemia PMDD Obesity Kidney stones
Preexisting Conditions: Obesity Migraine PMDD
Allergies: Allergies Hydrocodone-acetaminophen Oxycodone-acetaminophen Sulfa (sulfonamide Antibiotics) Tramadol Tramadol
Diagnostic Lab Data: CBC EKG
CDC 'Split Type':

Write-up: Anaphylactic with throat swelling , tachycardia and high BP. Pt was given steroids, epi pen, Benadryl and observed in ICU overnight.


Changed on 5/14/2021

VAERS ID: 907485 Before After
VAERS Form:2
Age:47.0
Sex:Female
Location:California
Vaccinated:2020-12-23
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Electrocardiogram, Full blood count, Hypertension, Intensive care, Tachycardia, Pharyngeal swelling

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: azelastine 137 mcg (0.1 %) nasal spray Commonly known as: ASTELIN buPROPion XL 150 mg 24 hr tablet Commonly known as: WELLBUTRIN XL cholecalciferol 50 mcg (2,000 unit) tablet Commonly known as: VITAMIN D3 doxycycline hyclate 100 mg capsule
Current Illness: Obstructive sleep apnea hypopnea, mild Pre-diabetes Other migraine without status migrainosus, not intractable Dyslipidemia PMDD Obesity Kidney stones
Preexisting Conditions: Obesity Migraine PMDD
Allergies: Allergies Hydrocodone-acetaminophen Oxycodone-acetaminophen Sulfa (sulfonamide Antibiotics) Tramadol Tramadol
Diagnostic Lab Data: CBC EKG
CDC 'Split Type':

Write-up: Anaphylactic with throat swelling , tachycardia and high BP. Pt was given steroids, epi pen, Benadryl and observed in ICU overnight.

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