VAERS ID: |
902728 (history) |
Form: |
Version 2.0 |
Age: |
34.0 |
Sex: |
Female |
Location: |
Texas |
Vaccinated: | 2020-12-15 |
Onset: | 2020-12-16 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
2020-12-16 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
PAA156057 / 1 |
RA / IM |
Administered by: Private Purchased by: ? Symptoms: Peripheral swelling,
Product administered at inappropriate site SMQs:, Cardiac failure (broad), Angioedema (broad), Drug abuse and dependence (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: BCPs (birth control pills) Current Illness: None Preexisting Conditions: MigRaines as 12/16/20 Allergies: Penicillin + Sulfa Diagnostic Lab Data: (-) CDC Split Type:
Write-up: Swelling on arm. Placement lower than deltoid, 4 cm. treated with corticosteroids, antihistamines |