National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 9/17/2021 release of VAERS data:

This is VAERS ID 1415923



Case Details

VAERS ID: 1415923 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
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 EW3143 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Injection site swelling, Lymphadenopathy, Pain in extremity, SARS-CoV-2 test
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Lactation decreased
Allergies:
Diagnostic Lab Data: Test Date: 20210605; Test Name: COVID-19 virus test; Test Result: Negative ; Comments: No - Negative COVID-19 test
CDC Split Type: GBPFIZER INC2021657533

Write-up: Chills; Pain in arm; Headache; Tiredness; Injection site swelling; Swollen lymph nodes; This is a spontaneous report from a contactable consumer received from the Regulatory Authorioty (RA). The regulatory authority report number is GB-MHRA-WEBCOVID-202106051724311280-UVZBX, Safety Report Unique Identifier GB-MHRA-ADR 25426197. A 32-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), unknown dose via an unspecified route of administration on 03Jun2021 (Lot Number: Ew3143) as single dose for COVID-19 immunisation. Patient has not had symptoms associated with COVID-19. Patient is not enrolled in clinical trial. Patient is not currently breastfeeding. Medical history included suppressed lactation from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. The patient experienced chills, pain in arm, headache, tiredness, injection site swelling, swollen lymph nodes, all on 04Jun2021 and reported as serious due to Medically significant. The patient underwent lab test and procedure which included sars-cov-2 test with the result of No - Negative COVID-19 test on 05Jun2021. Patient has not tested positive for COVID-19 since having the vaccine. The outcome of the event chills was recovering, of headache and swollen lymph nodes was recovered, of others was not recovered. No follow-up attempts are possible. No further information is expected


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1415923


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