VAERS ID: |
902839 (history) |
Form: |
Version 2.0 |
Age: |
58.0 |
Sex: |
Female |
Location: |
Alaska |
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 |
EK5730 / 1 |
LA / IM |
Administered by: Private Purchased by: ? Symptoms: Injection site pain,
Injection site swelling SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
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: None Current Illness: None Preexisting Conditions: Colitis secondary to possible Crohn''s disease, Inflammatory Polyarthropathy Allergies: Adhesive Bandages, Bactrim abx Diagnostic Lab Data: None CDC Split Type:
Write-up: Local pain and swelling of the injection site |