National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1412002

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1412002
VAERS Form:2
Age:28.0
Sex:Female
Location:Foreign
Vaccinated:2021-06-03
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY2173 / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Body temperature, Dyspnoea, Pruritus, Swelling, Hypoaesthesia oral

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: Medical History/Concurrent Conditions: Atopy; Food allergy
Allergies:
Diagnostic Lab Data: Test Date: 20210603; Test Name: body temperature; Result Unstructured Data: Test Result:36.4 Centigrade; Comments: Before vaccination
CDC 'Split Type': JPPFIZER INC2021659067

Write-up: Dyspnoea; Numbness of lips; itching; swelling; This is a spontaneous report from the contactable physician received from the Regulatory Authority. The Regulatory authority report number is v21111760. The patient was 28-year-old female. Body temperature before the vaccinations was 36.4 degrees centigrade on 03Jun2021. The patient''s history according to the Vaccine Screening Questionnaire was atopy, allergy to shrimp, crab, squid. The patient''s concomitant drug was not provided. On 03Jun2021 at 14:00 (the day of vaccination, at the age of 28-year-old), the patient received the first dose of BNT162B2 (COMIRNATY, Intramuscular injection, Lot number: EY2173, expiration date: 31Aug2021), via an unspecified route of administration as a single dose for COVID-19 immunisation. On 03Jun2021 at 14:05 (the day of vaccination), the patient experienced dyspnoea, numbness of lips, itching. The outcome of the event was recovering on 03Jun2021 (The day of vaccination). Clinical course of the event was reported as follows: The patient experienced dyspnoea, numbness of lips, swelling a few minutes after vaccination. In addition, before vaccination, the patient did not eat meat that can cause allergy. So the relationship assessed as related. After administration of antihistamine, the symptoms was recovering. The reporter classified the event as non-serious and the causality between the event and the vaccines was Related. Other possible cause of the event such as any other diseases was no.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1412002&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166