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This is VAERS ID 1266019

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1266019
VAERS Form:2
Age:50.0
Sex:Female
Location:Oregon
Vaccinated:2021-04-06
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / -

Administered by: Unknown      Purchased by: ??
Symptoms: Abdominal pain upper, Diarrhoea, Rectal haemorrhage

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Contrast media allergy; Lung neoplasm malignant; Shellfish allergy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC2021414761

Write-up: This is a spontaneous report from a contactable consumer (patient). A 50-year-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: EW0151; Expiration date was not reported) on the left arm on 06Apr2021 (15:00) as a single dose, with route of administration unspecified, for COVID-19 immunization. Medical history included neuroendocrine lung cancer, asthma, and allergies to shellfish and IV contrast dye. The patient''s concomitant medications were not reported. The patient was not pregnant at the time of vaccination. The patient had previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: EP7534; Expiration date was not reported) on 15Mar2021 (when the patient was 50 years old) for COVID-19 immunization. On 11Apr2021 (03:00), the patient had rectal bleeding, stomach cramps and diarrhea. The events were assessed as serious (medically significant), and had resulted into an emergency room/department or urgent care. The patient had received unspecified intravenous (IV) fluids as treatment for the reported events. The outcome of the events was recovering. The patient was not diagnosed with COVID-19 prior to vaccination, and had not been tested post-vaccination.


Changed on 5/7/2021

VAERS ID: 1266019 Before After
VAERS Form:2
Age:50.0
Sex:Female
Location:Oregon
Vaccinated:2021-04-06
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / -

Administered by: Unknown      Purchased by: ??
Symptoms: Abdominal pain upper, Diarrhoea, Rectal haemorrhage

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Contrast media allergy; Lung neoplasm malignant; Shellfish allergy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC2021414761

Write-up: This is a spontaneous report from a contactable consumer (patient). A 50-year-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: EW0151; Expiration date was not reported) on the left arm on 06Apr2021 (15:00) as a single dose, with route of administration unspecified, for COVID-19 immunization. Medical history included neuroendocrine lung cancer, asthma, and allergies to shellfish and IV contrast dye. The patient''s concomitant medications were not reported. The patient was not pregnant at the time of vaccination. The patient had previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: EP7534; Expiration date was not reported) on 15Mar2021 (when the patient was 50 years old) for COVID-19 immunization. On 11Apr2021 (03:00), the patient had rectal bleeding, stomach cramps and diarrhea. The events were assessed as serious (medically significant), and had resulted into an emergency room/department or urgent care. The patient had received unspecified intravenous (IV) fluids as treatment for the reported events. The outcome of the events was recovering. The patient was not diagnosed with COVID-19 prior to vaccination, and had not been tested post-vaccination.


Changed on 5/14/2021

VAERS ID: 1266019 Before After
VAERS Form:2
Age:50.0
Sex:Female
Location:Oregon
Vaccinated:2021-04-06
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 LA / -

Administered by: Unknown      Purchased by: ??
Symptoms: Abdominal pain upper, Diarrhoea, Rectal haemorrhage

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Contrast media allergy; Lung neoplasm malignant; Shellfish allergy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC2021414761

Write-up: This is a spontaneous report from a contactable consumer (patient). A 50-year-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: EW0151; Expiration date was not reported) on the left arm on 06Apr2021 (15:00) as a single dose, with route of administration unspecified, for COVID-19 immunization. Medical history included neuroendocrine lung cancer, asthma, and allergies to shellfish and IV contrast dye. The patient''s concomitant medications were not reported. The patient was not pregnant at the time of vaccination. The patient had previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: EP7534; Expiration date was not reported) on 15Mar2021 (when the patient was 50 years old) for COVID-19 immunization. On 11Apr2021 (03:00), the patient had rectal bleeding, stomach cramps and diarrhea. The events were assessed as serious (medically significant), and had resulted into an emergency room/department or urgent care. The patient had received unspecified intravenous (IV) fluids as treatment for the reported events. The outcome of the events was recovering. The patient was not diagnosed with COVID-19 prior to vaccination, and had not been tested post-vaccination.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1266019&WAYBACKHISTORY=ON


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