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This is VAERS ID 1379727

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1379727
VAERS Form:2
Age:32.0
Sex:Female
Location:Washington
Vaccinated:2021-05-28
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pustule, Rash, Rash pruritic

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: Amitriptyline 25mg, Topiramate 25mg, Sumatriptan 50mg, and Alprazolam 1mg
Current Illness:
Preexisting Conditions: Migraine headache, depression, anxiety
Allergies: no known drug allergies
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient''s husband reported that patient noticed on 6/4/2021 bumps and itchy rash on her stomach , side of torso, and back (not as prominent on back). Bumps and rash have grown in size and seem pustule and "zit-like". Patient will continue to monitor rash size and temperature. If any drastic changes in temperature or rash size/status, patient will seek medical attention.

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