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This is VAERS ID 1408505

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1408505
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Chills, Headache, SARS-CoV-2 test

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: LUCETTE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Lactation decreased
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative ; Comments: No - Negative
CDC 'Split Type': GBPFIZER INC2021640651

Write-up: Shivers; Headache; This is a spontaneous report from a contactable consumer received from the Regulatory Authority (RA). The regulatory authority report number is GB-MHRA-WEBCOVID-202106011923558370-YHSLG. Safety Report Unique Identifier is GB-MHRA-ADR 25400916. A 33-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) dose 1 via an unspecified route of administration on 31May2021 (lot number and expiry date: unknown) as 1st dose, single for COVID-19 immunisation. Medical history included lactation decreased. Patient has not had symptoms associated with COVID-19. Patient is not enrolled in clinical trial. Patient is not pregnant. Patient is not currently breastfeeding. Concomitant medication included drospirenone, ethinylestradiol (LUCETTE) taken for an unspecified indication, start and stop date were not reported. The patient experienced shivers and headache on 01Jun2021. The events were considered serious due to other medically important condition. The patient underwent lab tests and procedures which included COVID-19 virus test: no-negative on an unspecified date. Patient has not tested positive for COVID-19 since having the vaccine. Outcome of the events was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.

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