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This is VAERS ID 1382048

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1382048
VAERS Form:2
Age:12.0
Sex:Male
Location:Florida
Vaccinated:2021-05-22
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 EN6205 / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Blood lactate dehydrogenase normal, Blood uric acid normal, Differential white blood cell count normal, Full blood count normal, Lymph node pain, Lymphadenopathy, Metabolic function test normal

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: MMR - 6 months old; rash
Other Medications: Budesonide nasal spray 2 sprays each nostril once daily Miralax prn
Current Illness: none
Preexisting Conditions: Allergic rhinitis Asthma
Allergies: EGGS
Diagnostic Lab Data: CMP, CBC with diff, LDH, uric acid obtained 6/7/21; all labs normal
CDC 'Split Type':

Write-up: Day 13 after Pfizer vaccine, patient felt a lump below clavicle on R side Saw Dr. 6/5 - per prescriber, ~ 1.5 cm lymph node subclavicle; tender, discrete, moveable No other lymph nodes of concern As of 6/8 - lymph node still same size

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