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This is VAERS ID 1331313

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1331313
VAERS Form:2
Age:14.0
Sex:Female
Location:New York
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 EW0186 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Injection site erythema, Injection site pruritus

Life Threatening? No
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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: none
Allergies: nickle
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Within minutes of injection patient developed redness at injection site. Redness and itching progressed down left arm and into left hand in patches. Administered 50 mg diphenhydramine 10 minutes after vaccine administration.

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