VAERS ID: |
902983 (history) |
Form: |
Version 2.0 |
Age: |
26.0 |
Sex: |
Female |
Location: |
California |
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: Private Purchased by: ? Symptoms: Chills,
Fatigue,
Headache,
Injection site pain,
Myalgia,
Pyrexia SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (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: 2000 IU Vitamin D q day Current Illness: None Preexisting Conditions: None Allergies: None Diagnostic Lab Data: CDC Split Type:
Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA. Injection site pain, headache, tiredness, muscle pain, chills and fever. Took acetaminophen, no longer have fever after 12 hrs. |