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This is VAERS ID 1329863

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1329863
VAERS Form:2
Age:13.0
Sex:Female
Location:Michigan
Vaccinated:2021-05-17
Onset:2021-05-18
Submitted:0000-00-00
Entered:2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site rash, Rash, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: 3 CM edematic rash at injection site-Medium, Additional Details: Shot may have been given lower than should have in arm as well

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1329863&WAYBACKHISTORY=ON


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