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VAERS ID: | 902835 |
VAERS Form: | 2 |
Age: | 50.0 |
Sex: | Female |
Location: | South Dakota |
Vaccinated: | 2020-12-16 |
Onset: | 2020-12-16 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-16 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EH9899 / 1 | LA / IM |
Administered by: Private Purchased by: ??
Symptoms: Injection site pain, Injection site swelling, Immediate post-injection reaction
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Immediately after injection of vaccination her left deltoid started swelling. Complains of pain at injection site. No other complaints. Applied ice. She took Tylenol and Benedryl. Stayed 30 minutes after vaccination without further complaint.
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