VAERS ID: |
902908 (history) |
Form: |
Version 2.0 |
Age: |
44.0 |
Sex: |
Male |
Location: |
Oklahoma |
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 |
- / 1 |
LA / IM |
Administered by: Work Purchased by: ? Symptoms: Arthralgia,
Fatigue,
Feeling hot,
Pruritus SMQs:, Anaphylactic reaction (broad), Hypersensitivity (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? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Ambien, Dyazide, Celecoxib, Allegra Current Illness: None Preexisting Conditions: Migraines, asthma Allergies: Cherry, almonds, sulfa drugs Diagnostic Lab Data: None CDC Split Type:
Write-up: Extreme fatigue, felt very warm all over body for 14 - 16 hours, exceptional pruritus on head and back, all joints are exceptionally achey |