| VAERS ID: |
909577 (history) |
| Form: |
Version 2.0 |
| Age: |
60.0 |
| Sex: |
Female |
| Location: |
Michigan |
| Vaccinated: | 2020-12-26 |
| Onset: | 2020-12-26 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-27 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EK9231 / 1 |
AR / IM |
Administered by: Private Purchased by: ?
Symptoms: Dizziness,
Dyspnoea,
Full blood count,
Laboratory test,
Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
Extended hospital stay? No
Previous Vaccinations:
Other Medications: Estrogen, Flonase, Protonix, Glucosamine, Albuterol
Current Illness: Viral respiratory infection
Preexisting Conditions: Allergic rhinitis, GERD, endometriosis
Allergies: Avocado, Banana, Latex, Neosporin, Nystatin, Sulfa, Pineapple
Diagnostic Lab Data: Routine chemistries, CBC
CDC Split Type:
Write-up: Dizziness, dyspnea, neck swelling |
