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VAERS ID: | 909577 |
VAERS Form: | 2 |
Age: | 60.0 |
Sex: | Female |
Location: | Michigan |
Vaccinated: | 2020-12-26 |
Onset: | 2020-12-26 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-27 |
Vaccination / Manufacturer (1 vaccine) | 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, Swelling, Laboratory test
Life Threatening? Yes
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? Yes, days: 1
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
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