VAERS ID: |
902989 (history) |
Form: |
Version 2.0 |
Age: |
33.0 |
Sex: |
Female |
Location: |
Nebraska |
Vaccinated: | 2020-12-15 |
Onset: | 2020-12-16 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
2020-12-17 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / 1 |
LA / IM |
Administered by: Private Purchased by: ? Symptoms: Body temperature increased,
Fatigue,
Headache SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Levothyroxine, Norethindrone, prenatal vitamin Current Illness: None Preexisting Conditions: Hypothyroidism Allergies: Penicillins Diagnostic Lab Data: none CDC Split Type:
Write-up: Headache, fatigue, temperature of 100.3. Lasted about 8 hours. |