| VAERS ID: |
902841 (history) |
| Form: |
Version 2.0 |
| Age: |
44.0 |
| 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: Allergic Rhinitis, Anxiety, Migraine with Aura, Obesity, PTSD, Sleep Apnea, Subclinical Hypothyroidism, Tobacco Use
Allergies: Sertraline, Penicillins -- described as mild rash only
Diagnostic Lab Data: None
CDC Split Type:
Write-up: Local Pain and swelling of the injection site |
