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This is VAERS ID 942029

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/22/2021

VAERS ID: 942029
VAERS Form:2
Age:43.0
Sex:Female
Location:Tennessee
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2021-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 RA / IM

Administered by: Work      Purchased by: ??
Symptoms: Anaphylactic shock, Throat tightness, Urticaria

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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft, Valsartan, propranolol, lasix,
Current Illness: None
Preexisting Conditions: Htn, asthma, diabetes environmental allergies
Allergies: Contrast dye, triptans, Topamax, imitrex,reception, pravastatin, CATS( HAIR AND DANDER, pfizer-biontech covid 19 vaccine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: I received my covid vaccine on 12/29/2020 at 4:42pm. In 10 minutes after the shot, I went into anaphylactic shock, I broke out in hives, and my throat was closing


Changed on 5/7/2021

VAERS ID: 942029 Before After
VAERS Form:2
Age:43.0
Sex:Female
Location:Tennessee
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2021-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 RA / IM

Administered by: Work      Purchased by: ??
Symptoms: Anaphylactic shock, Throat tightness, Urticaria

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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft, Valsartan, propranolol, lasix,
Current Illness: None
Preexisting Conditions: Htn, asthma, diabetes environmental allergies
Allergies: Contrast dye, triptans, Topamax, imitrex,reception, pravastatin, CATS( HAIR AND DANDER, pfizer-biontech covid 19 vaccine vaccine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: I received my covid vaccine on 12/29/2020 at 4:42pm. In 10 minutes after the shot, I went into anaphylactic shock, I broke out in hives, and my throat was closing


Changed on 5/21/2021

VAERS ID: 942029 Before After
VAERS Form:2
Age:43.0
Sex:Female
Location:Tennessee
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2021-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 RA / IM

Administered by: Work      Purchased by: ??
Symptoms: Anaphylactic shock, Throat tightness, Urticaria

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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft, Valsartan, propranolol, lasix,
Current Illness: None
Preexisting Conditions: Htn, asthma, diabetes environmental allergies
Allergies: Contrast dye, triptans, Topamax, imitrex,reception, pravastatin, CATS( HAIR AND DANDER, pfizer-biontech covid 19 vaccine vaccine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: I received my covid vaccine on 12/29/2020 at 4:42pm. In 10 minutes after the shot, I went into anaphylactic shock, I broke out in hives, and my throat was closing

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