| VAERS ID: |
902764 (history) |
| Form: |
Version 2.0 |
| Age: |
71.0 |
| Sex: |
Female |
| Location: |
North Carolina |
| Vaccinated: | 2020-12-15 |
| Onset: | 2020-12-15 |
| 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 / UNK |
- / - |
Administered by: Military Purchased by: ?
Symptoms: Injection site bruising,
Injection site pain,
Injection site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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: Levothyroxine 88MCG/once daily, Losartan 100MG/once daily, PravastatinSodium 20MG/once daily, Protonix40MG/twice daily, aspirin 81MG/once daily, Calcium1000, Magnesium400,Zinc15/once daily
Current Illness: None
Preexisting Conditions: Controlled by medication: high blood pressure, thyroid, heartburn, leg cramps
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:
Write-up: .5 inch bruise at injection site, slight swelling, sore muscle, ibuprofen, ice bag, |
