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This is VAERS ID 950996

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 950996
VAERS Form:2
Age:57.0
Sex:Female
Location:New Jersey
Vaccinated:2021-01-15
Onset:2021-01-15
Submitted:0000-00-00
Entered:2021-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH CZ3248 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Headache, Thrombosis

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: Vitamins Amitryptaline
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None.
CDC 'Split Type':

Write-up: Constant headache began approximately 1 hr after receiving vaccine. Awoke this morning with blood clots on my tongue


Changed on 5/7/2021

VAERS ID: 950996 Before After
VAERS Form:2
Age:57.0
Sex:Female
Location:New Jersey
Vaccinated:2021-01-15
Onset:2021-01-15
Submitted:0000-00-00
Entered:2021-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH CZ3248 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Headache, Thrombosis

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: Vitamins Amitryptaline
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: None.
CDC 'Split Type':

Write-up: Constant headache began approximately 1 hr after receiving vaccine. Awoke this morning with blood clots on my tongue


Changed on 5/14/2021

VAERS ID: 950996 Before After
VAERS Form:2
Age:57.0
Sex:Female
Location:New Jersey
Vaccinated:2021-01-15
Onset:2021-01-15
Submitted:0000-00-00
Entered:2021-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH CZ3248 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Headache, Thrombosis

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: Vitamins Amitryptaline
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: None.
CDC 'Split Type':

Write-up: Constant headache began approximately 1 hr after receiving vaccine. Awoke this morning with blood clots on my tongue

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