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This is VAERS ID 1379747

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1379747
VAERS Form:2
Age:35.0
Sex:Female
Location:California
Vaccinated:2021-06-04
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 EW0187 / 2 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Arthralgia, Injection site pain, Immediate post-injection reaction, Wrong technique in product usage process

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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa drugs, fluroquinolones
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shot was placed too high on arm. Shot was given too high/too deep. Experience immediate intense injection pain. Likely pierced bursa. Improper and poor technique. Reported to administrator of shot and emt on site. 3 days later having shoulder pain.

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