VAERS ID: |
902745 (history) |
Form: |
Version 2.0 |
Age: |
43.0 |
Sex: |
Female |
Location: |
Puerto Rico |
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 |
LA / IM |
Administered by: Work Purchased by: ? Symptoms: Injected limb mobility decreased,
Injection site oedema,
Injection site pain,
Musculoskeletal chest pain,
Myalgia,
Pain,
Painful respiration,
Paraesthesia SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: ASTHMA, SLEEP APNEA, PSEUDOMOTOR CEREBRI Allergies: DEMEROL Diagnostic Lab Data: CDC Split Type:
Write-up: PAIN AND EDEMA AT SITE OF INJECTION LEFT ARM WITH DECREASED RANGE OF MOTION LEFT ARM RIB CAGE PAIN ON INSPIRATION MUSCLE PAIN RIGHT AND LEFT THIGHS, WORSENING UPON AMBULATION MUSCLE PAIN AND TINGLING RIGHT UPPER EXTREMITY AND BACK |