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

This is VAERS ID 1416023



Case Details

VAERS ID: 1416023 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
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: Feeling abnormal, Pain in extremity, SARS-CoV-2 test, Sleep disorder
SMQs:, Dementia (broad), Tendinopathies and ligament disorders (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: METHYLPHENIDATE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Asthmatic; Attention deficit hyperactivity disorder; Lactation decreased
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative
CDC Split Type: GBPFIZER INC2021657961

Write-up: felt poorly (general brain fog); Painful arm; Sleep disturbance; This is a spontaneous report from a contactable Consumer(patient). This is a report received from the Regulatory Agency. Regulatory authority report number GB-MHRA-WEBCOVID-202106052102247390-53DPW, Safety Report Unique Identifier GB-MHRA-ADR 25426468. A 23-year-old female patient received bnt162b2 (BNT162B2), via an unspecified route of administration in arm on 03Jun2021 at her 23-year-old (Lot Number: Ew3143) as 1st dose, single for covid-19 immunisation. Medical history included suppressed lactation, asthmatic, attention deficit hyperactivity disorder. Patient had not had symptoms associated with COVID-19. Patient was not enrolled in clinical trial. Patient was not pregnant, Patient was not currently breastfeeding. Concomitant medications included methylphenidate taken for attention deficit hyperactivity disorder from 10May2021 to an unspecified stop date. The patient experienced painful arm on 03Jun2021 with outcome of recovering , sleep disturbance on 03Jun2021 with outcome of recovered, felt poorly (general brain fog) on an unspecified date with outcome of unknown. All events were assessed as medically significant. Lab data included COVID-19 virus test: negative on unknown date. The clinical course was reported as follows: Hours after jab arm was really painful. Couldn''t sleep on the side and couldn''t lift the arm at shoulder height for 2 days. First night of sleep was very disrupted and she felt poorly (general brain fog) and feeling under the weather. Patient had not tested positive for COVID-19 since having the vaccine. No follow-up attempts are possible. No further information is expected.


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