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VAERS ID: | 902906 |
VAERS Form: | 2 |
Age: | 31.0 |
Sex: | Male |
Location: | Connecticut |
Vaccinated: | 2020-12-16 |
Onset: | 2020-12-16 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-17 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EH9899 / UNK | LA / SYR |
Administered by: Private Purchased by: ??
Symptoms: Arthralgia, Chills, Fatigue, Headache, Injection site pain, Myalgia, Nausea, Pyrexia, Respiratory tract congestion
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: History of transposition of great vessels at birth
Allergies: NKDA
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Chills approx 6 hours after receiving shot Injection site tenderness (no redness or swelling noted) Muscle aches and joint pain at 8 hours At 12 hours, fatigue, nausea (20 minutes), headache, congestion, low grade temp 99.5, malaise Hour 17 fever to 100.5 took 800 mg Advil and 1000 mg Tylenol. Hour 24 all symptoms completely resolved only very mild injection site tenderness. Felt at baseline. Afebrile.
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