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This is VAERS ID 913239

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 913239
VAERS Form:2
Age:45.0
Sex:Female
Location:California
Vaccinated:2020-12-28
Onset:2020-12-28
Submitted:0000-00-00
Entered:2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 03/2021 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Asthenia, Chest pain, Heart rate increased, Oesophageal pain, Palpitations

Life Threatening? Yes
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: unknown
Current Illness: denied
Preexisting Conditions: unknown
Allergies: denied hx of allergy or anaphylaxis
Diagnostic Lab Data: Pulse was measured at 170-180 range, very regular, no EKG machine was available so an SVT was considered possibly triggered by stress as another staff member was developing anaphylaxis near by. Pt. was calm and denied anxiety except with regard to her palpitations and mid sternal burning. O2 sat was 100% on room air, no respiratory, cutaneous or G.I. symptoms at the time of onset. Since pulse and symptoms did not diminish over the next 15 minutes we transported her to our E.R. where she subsequently also underwent treatment for anaphylaxis with Epinephrine, benedryl, steroids and multiple liters of fluid to which she responded and stabilized.
CDC 'Split Type':

Write-up: Pt. began to feel weak with palpitations about 8-10 minutes after vaccination, her pulse was extremely fast, she then began to complain of lower mid-esophageal burning


Changed on 5/7/2021

VAERS ID: 913239 Before After
VAERS Form:2
Age:45.0
Sex:Female
Location:California
Vaccinated:2020-12-28
Onset:2020-12-28
Submitted:0000-00-00
Entered:2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 03/2021 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Asthenia, Chest pain, Heart rate increased, Oesophageal pain, Palpitations

Life Threatening? Yes
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: unknown
Current Illness: denied
Preexisting Conditions: unknown
Allergies: denied hx of allergy or anaphylaxis anaphylaxis
Diagnostic Lab Data: Pulse was measured at 170-180 range, very regular, no EKG machine was available so an SVT was considered possibly triggered by stress as another staff member was developing anaphylaxis near by. Pt. was calm and denied anxiety except with regard to her palpitations and mid sternal burning. O2 sat was 100% on room air, no respiratory, cutaneous or G.I. symptoms at the time of onset. Since pulse and symptoms did not diminish over the next 15 minutes we transported her to our E.R. where she subsequently also underwent treatment for anaphylaxis with Epinephrine, benedryl, steroids and multiple liters of fluid to which she responded and stabilized.
CDC 'Split Type':

Write-up: Pt. began to feel weak with palpitations about 8-10 minutes after vaccination, her pulse was extremely fast, she then began to complain of lower mid-esophageal burning


Changed on 5/14/2021

VAERS ID: 913239 Before After
VAERS Form:2
Age:45.0
Sex:Female
Location:California
Vaccinated:2020-12-28
Onset:2020-12-28
Submitted:0000-00-00
Entered:2020-12-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 03/2021 / 1 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Asthenia, Chest pain, Heart rate increased, Oesophageal pain, Palpitations

Life Threatening? Yes
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: unknown
Current Illness: denied
Preexisting Conditions: unknown
Allergies: denied hx of allergy or anaphylaxis anaphylaxis
Diagnostic Lab Data: Pulse was measured at 170-180 range, very regular, no EKG machine was available so an SVT was considered possibly triggered by stress as another staff member was developing anaphylaxis near by. Pt. was calm and denied anxiety except with regard to her palpitations and mid sternal burning. O2 sat was 100% on room air, no respiratory, cutaneous or G.I. symptoms at the time of onset. Since pulse and symptoms did not diminish over the next 15 minutes we transported her to our E.R. where she subsequently also underwent treatment for anaphylaxis with Epinephrine, benedryl, steroids and multiple liters of fluid to which she responded and stabilized.
CDC 'Split Type':

Write-up: Pt. began to feel weak with palpitations about 8-10 minutes after vaccination, her pulse was extremely fast, she then began to complain of lower mid-esophageal burning

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