VAERS ID: |
902706 (history) |
Form: |
Version 2.0 |
Age: |
30.0 |
Sex: |
Female |
Location: |
Minnesota |
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 |
EH9899 / 1 |
- / IM |
Administered by: Private Purchased by: ? Symptoms: Chills,
Nausea,
Pain SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Zoloft, post-natal vitamin, dha, vitamin d Current Illness: None Preexisting Conditions: None Allergies: Dairy, gluten, morphine allergies Diagnostic Lab Data: CDC Split Type:
Write-up: Bp of 85/44, nauseous, body aches, chills |