National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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

This is VAERS ID 1320195

Case Details

VAERS ID: 1320195 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Maryland  
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: ?
Symptoms: Pain in extremity, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
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
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021493664

Write-up: Hives all over her body; Rash all over her body; Pain in arm; This is a spontaneous report from a Pfizer-Sponsored program from a contactable consumer (patient). A 52-year-old female patient received the 1st dose of bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), via an unspecified route of administration in deltoid left, on 21Apr2021 (Lot Number: EW0172), as single dose, for COVID-19 immunisation. Medical history was none. No history of allergies or autoimmune disease. Concomitant medications were not reported. The patient experienced hives all over her body (medically significant) on 02May2021 with outcome of not recovered, rash all over her body (medically significant) on 02May2021 with outcome of not recovered, pain in arm (non-serious) on 02May2021 with outcome of unknown. Therapeutic measures were taken as a result of hives all over her body and rash all over her body and included treatment with antihistamine, Benadryl. Follow-up attempts are needed. Further information is expected.

New Search

Link To This Search Result:

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