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This is VAERS ID 1299361

History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2021

VAERS ID: 1299361
VAERS Form:2
Age:29.0
Sex:Female
Location:Michigan
Vaccinated:2021-04-30
Onset:2021-05-02
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, Thrombosis, SARS-CoV-2 test

Life Threatening? Yes
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? Yes, days: 3     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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