National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/26/2021 release of VAERS data:

This is VAERS ID 1205252

Government Disclaimer on use of this data



Case Details

VAERS ID: 1205252 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-01-20
Onset:2021-01-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 RA / OT

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Face oedema, Flushing, Incorrect route of product administration, Pericarditis, Tachycardia, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug abuse and dependence (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
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: Medical History/Concurrent Conditions: COVID-19; Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021374346

Write-up: pericarditis; SOB; facial edema; wheezing; flushing; tachycardia; received the first dose of BNT162B2 via subcutaneous; This is a spontaneous report from a contactable nurse (patient). A 33-year-old female patient received the first dose of BNT162B2 (Lot Number: EJ1686), subcutaneous, administered in right arm on 20Jan2021 13:15 (at the age of 33-year-old) as single dose for COVID-19 immunization. Medical history included penicillin allergy and COVID-19 on 28Dec2020. The patient is not pregnant. The patient''s concomitant medications were not reported. The patient did not received any other vaccines within 4 weeks prior to the COVID vaccine. On 20Jan2021 13:30, the patient experienced SOB, facial edema, wheezing, flushing, tachycardia and pericarditis. The adverse events resulted in Doctor or other healthcare Professional office/clinic visit, Life Threatening illness (immediate risk of death from the event). Therapeutic measures were taken as a result of the events which included Epinephrine, prednisone, albuterol, diphenhydramine. The outcome of the events was recovered with sequelae.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1205252


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166