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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1415884



Case Details

VAERS ID: 1415884 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Myalgia, Nausea, Occult blood positive, Peripheral swelling, Pyrexia, SARS-CoV-2 test, Vaccination site pain, Vaccination site swelling, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Anorexia nervosa; Immunodeficiency; Lactation decreased
Allergies:
Diagnostic Lab Data: Test Name: Q Fit Test; Test Result: Positive ; Comments: very raised levels; Test Name: COVID-19 virus test; Test Result: Negative
CDC Split Type: GBPFIZER INC2021657461

Write-up: Painful swelling at the injection site; Painful swelling at the injection site; diarrhoea; chills; nausea; dizziness; Fever; Unilateral leg swelling; Vomiting; Muscle ache; Swollen arm; This is a spontaneous report from a contactable consumer received from the Regulatory Authority . The regulatory authority report number is GB-MHRA-WEBCOVID-202106051305595790-VHELY, Safety Report Unique Identifier GB-MHRA-ADR 25425788. A 27-year-old female patient received First dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 03Jun2021 (Lot number was not reported) as 1st dose single for covid-19 immunisation. Medical history included anorexia nervosa, Lactation decreased, immunodeficiency. 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. The patient''s concomitant medications were not reported. The patient experienced painful swelling at the injection site, diarrhoea, chills, nausea, dizziness all on an unspecified date, fever, unilateral leg swelling, vomiting, muscle ache, swollen arm all on 04Jun2021. The patient had positive Q Fit Test result: very raised levels, test conducted due to frequent diarrhoea and blood loss, COVID-19 virus tested negative on unspecified date. Patient has not tested positive for COVID-19 since having the vaccine. Outcome of Fever was recovering, Unilateral leg swelling, Muscle ache, Swollen arm was not recovered, Vomiting was recovered, other events outcome were unknown. Case reported serious due to Other medically important condition. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.


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