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This is VAERS ID 1331307

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1331307
VAERS Form:2
Age:12.0
Sex:Female
Location:California
Vaccinated:2021-05-19
Onset:2021-05-19
Submitted:0000-00-00
Entered:2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Pruritus

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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Amoxicillin
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Client complained of itchiness to throat, right arm, left foot, abdomen, and right temple. Denied any difficulty breath or shortness of breath. Able to drink water without difficulties. Offered Benadryl IM. Vital signs stable. B/P 110/56 HR 74 RR 18 O2 Sats 100%. No distress noted.

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