National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

From the 1/14/2022 release of VAERS data:

This is VAERS ID 1018731

Government Disclaimer on use of this data



Case Details

VAERS ID: 1018731 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-01-11
Onset:2021-01-01
Submitted: 0000-00-00
Entered: 2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Petechiae, Purpura, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021070427

Write-up: abdominal pain; rash on legs; Rash continues 1 weeks later with purpura, petechiae with no itching or pain; Rash continues 1 weeks later with purpura, petechiae with no itching or pain; This is a spontaneous report from a contactable 34-year-old female nurse (patient) reported for herself that she received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number=EK9231), via an unspecified route of administration at left arm on 11Jan2021 08:00 AM at single dose for covid-19 immunization. Facility where the most recent COVID-19 vaccine administered was hospital. The patient medical history and concomitant medication was none. Historical vaccine included the first dose of BNT162B2 (lot number=EK5730) on 21Dec2020 08:00 AM at left arm for COVID-19 immunization. Not pregnant at the time of vaccination. On 19Jan2021 12:00 AM, the patient developed abdominal pain and rash on legs; rash continued 1 weeks later with purpura and petechiae (Jan2021) with no itching or pain. Doctor or other healthcare professional office/clinic visit was reported. It was reported as non-serious. Unknown if treatment was received for the events. Outcome of events was not recovered. No other vaccine in four weeks. No covid prior vaccination. No covid tested post vaccination.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1018731


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166