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This is VAERS ID 956642

History of Changes from the VAERS Wayback Machine

First Appeared on 1/22/2021

VAERS ID: 956642
VAERS Form:2
Age:44.0
Sex:Female
Location:Colorado
Vaccinated:2021-01-09
Onset:2021-01-14
Submitted:0000-00-00
Entered:2021-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK 9231 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Deep vein thrombosis, Ultrasound scan abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: birth contol (over 10years same one ) trazadone, wellbutrin celexa
Current Illness: none
Preexisting Conditions: none
Allergies: penicillins
Diagnostic Lab Data: ultrasound 1.14.2021
CDC 'Split Type':

Write-up: Visited Provider appx 500 pm 1.14.2021 DVT - left calf - 2 clots via ultrasound on Eliquis now


Changed on 5/7/2021

VAERS ID: 956642 Before After
VAERS Form:2
Age:44.0
Sex:Female
Location:Colorado
Vaccinated:2021-01-09
Onset:2021-01-14
Submitted:0000-00-00
Entered:2021-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK 9231 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Deep vein thrombosis, Ultrasound scan abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: birth contol (over 10years same one ) trazadone, wellbutrin celexa
Current Illness: none
Preexisting Conditions: none
Allergies: penicillins penicillins
Diagnostic Lab Data: ultrasound 1.14.2021
CDC 'Split Type':

Write-up: Visited Provider appx 500 pm 1.14.2021 DVT - left calf - 2 clots via ultrasound on Eliquis now


Changed on 5/14/2021

VAERS ID: 956642 Before After
VAERS Form:2
Age:44.0
Sex:Female
Location:Colorado
Vaccinated:2021-01-09
Onset:2021-01-14
Submitted:0000-00-00
Entered:2021-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK 9231 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Deep vein thrombosis, Ultrasound scan abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: birth contol (over 10years same one ) trazadone, wellbutrin celexa
Current Illness: none
Preexisting Conditions: none
Allergies: penicillins penicillins
Diagnostic Lab Data: ultrasound 1.14.2021
CDC 'Split Type':

Write-up: Visited Provider appx 500 pm 1.14.2021 DVT - left calf - 2 clots via ultrasound on Eliquis now

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=956642&WAYBACKHISTORY=ON

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