VAERS ID: |
902829 (history) |
Form: |
Version 2.0 |
Age: |
23.0 |
Sex: |
Female |
Location: |
West Virginia |
Vaccinated: | 2020-12-16 |
Onset: | 2020-12-16 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
2020-12-16 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / UNK |
LA / IM |
Administered by: Senior Living Purchased by: ? Symptoms: Injection site erythema SMQs:, Extravasation events (injections, infusions and implants) (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Spironalctone 100mg daily, Metformin 1000mg dx daily, Naproxen 500mg daily, Progesterone 10mg injection, Stattwra 200mg daily Current Illness: unknown Preexisting Conditions: unknown Allergies: pertussis and hep B Diagnostic Lab Data: none CDC Split Type:
Write-up: Redness to injection site |