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This is VAERS ID 1391062

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1391062
VAERS Form:2
Age:14.0
Sex:Unknown
Location:Unknown
Vaccinated:2021-06-03
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Pain in extremity, Off label use

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC2021658898

Write-up: 14 yr old received the 2nd dose of the Pfizer Covid vaccination; Sore arm; This is a spontaneous report from a non-contactable consumer. A 14-year-old patient of an unspecified gender received second dose of BNT162B2 (Pfizer Covid vaccine, Solution for injection) via an unspecified route of administration on 03Jun2021 (Lot number was not reported) as single dose for Covid-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient previously took first dose of BNT162B2 (at age of 14-year-old) as single dose for Covid-19 immunization. It was reported that, 14-year-old received the second dose of the Pfizer Covid vaccination on 03Jun2021 and had a slight sore arm the following morning. Event took place after use of product. Reporter did not wish to be contacted for follow-up. Outcome of the events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

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