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This is VAERS ID 919584

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 919584
VAERS Form:2
Age:48.0
Sex:Female
Location:Unknown
Vaccinated:2021-01-03
Onset:2021-01-03
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Dizziness, Throat tightness

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: none
Allergies: azithromycin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lightheadedness, throat tightness. Increasing chest tightness. History of atrial fibrillation and bilateral breast implants. Received two doses of epinephrine and one dose of diphenhydramine.


Changed on 5/7/2021

VAERS ID: 919584 Before After
VAERS Form:2
Age:48.0
Sex:Female
Location:Unknown
Vaccinated:2021-01-03
Onset:2021-01-03
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Dizziness, Throat tightness

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: none
Allergies: azithromycin azithromycin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lightheadedness, throat tightness. Increasing chest tightness. History of atrial fibrillation and bilateral breast implants. Received two doses of epinephrine and one dose of diphenhydramine.


Changed on 5/14/2021

VAERS ID: 919584 Before After
VAERS Form:2
Age:48.0
Sex:Female
Location:Unknown
Vaccinated:2021-01-03
Onset:2021-01-03
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / -

Administered by: Private      Purchased by: ??
Symptoms: Chest discomfort, Dizziness, Throat tightness

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: none
Allergies: azithromycin azithromycin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lightheadedness, throat tightness. Increasing chest tightness. History of atrial fibrillation and bilateral breast implants. Received two doses of epinephrine and one dose of diphenhydramine.

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