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This is VAERS ID 1347615

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1347615
VAERS Form:2
Age:14.0
Sex:Male
Location:Oregon
Vaccinated:2021-05-22
Onset:2021-05-22
Submitted:0000-00-00
Entered:2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / UNK RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Throat tightness

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: None reported
Preexisting Conditions:
Allergies: Not on file
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient c/o throat "tightening" s/p Covid Pfizer#1. No respiratory distress. No hives or rash. Rx cetirizine 10 mg PO and diphenhydramine 25 mg PO with H2O, Observed x 30 min total. No worsening of symptoms. Discharged.

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