VAERS ID: |
902906 (history) |
Form: |
Version 2.0 |
Age: |
31.0 |
Sex: |
Male |
Location: |
Connecticut |
Vaccinated: | 2020-12-16 |
Onset: | 2020-12-16 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
2020-12-17 |
Vaccination / Manufacturer |
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 SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
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: 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. |