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This is VAERS ID 1368014

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1368014
VAERS Form:2
Age:12.0
Sex:Female
Location:Massachusetts
Vaccinated:2021-06-02
Onset:2021-06-02
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline, probiotic, vitamin D, Vitamin B supplement, Neuroflam supplement. l-theanine, Claritin nystatin 21 day course she completed on 5/29/21 Azithromycin was completed 10 days before vaccine.
Current Illness: Took antibiotics recently because it had dental work and doctor had advised it as a precaution. Took Nystatin because had fungal infection after antibiotic. She had a cold (negative Covid test) about 2 wks ago. Cold was resolved last week, she had a fever with this, and that was 13 days prior to the vaccine.
Preexisting Conditions: PANDAs
Allergies: PCN- rash and joint inflammation. Dust mites, mold, mild to pet dander.
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Rash on torso and legs

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