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From the 7/23/2021 release of VAERS data:

This is VAERS ID 1299361



Case Details

VAERS ID: 1299361 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-30
Onset:2021-05-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, SARS-CoV-2 test, Thrombosis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210502; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC2021494207

Write-up: Blood clot on the cerebellum that caused a stroke; Blood clot on the cerebellum that caused a stroke; This is a spontaneous report from a contactable consumer (patient). A 29-year-old female patient (not pregnant) received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Lot Number: EW0167), first dose via an unspecified route of administration, administered in Arm Left on 30Apr2021 11:30 (at 29 years old,(not pregnant), single dose for covid-19 immunisation. The patient''s medical history was not reported. The patient''s concomitant medication included an unspecified vitamin. The patient previously took ibuprofen and experienced Ibuprofen drug allergy. On 02May2021 08:30, patient experienced a Blood clot on the cerebellum that caused a stroke. The outcome of the events was recovering. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The adverse event resulted in visit to Emergency room/department or urgent care. Treatment received for the adverse event was Blood clot meds. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has been tested for COVID-19 (02May2021), negative for swab test. Events caused 3 days of hospitalization. Information on Lot/Batch number was available. Additional information has been requested.


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