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This is VAERS ID 598153

Case Details

VAERS ID: 598153 (history)  
Form: Version 1.0  
Age: 65.0  
Gender: Female  
Location: Vermont  
Vaccinated:2015-09-22
Onset:2015-09-24
   Days after vaccination:2
Submitted: 2015-10-01
   Days after onset:7
Entered: 2015-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH L43700 / 1 LA / IM

Administered by: Other       Purchased by: Public
Symptoms: Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left shoulder pain, persistent -rates 4/10 at rest and 8/10 with movement.


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