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This is VAERS ID 1417497

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1417497
VAERS Form:2
Age:46.0
Sex:Female
Location:Foreign
Vaccinated:2021-06-02
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Body temperature, Chest pain, Chills, Cough, Eye pain, Headache, Pain, Pain in extremity, Pyrexia, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NITROFURANTOIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Kidney stone
Allergies:
Diagnostic Lab Data: Test Date: 20210603; Test Name: fever; Result Unstructured Data: Test Result:37 to 39 Centigrade; Comments: at 20:00
CDC 'Split Type': BRPFIZER INC2021663416

Write-up: Fever between 37 to 39 degrees; headache; pain in eyes; body pain; chills; body strengthless; no appetite; pain in arm; cough; chest pain; This is a spontaneous report from a contactable consumer (patient). A 46-year-old female patient received first dose of BNT162B2 (COMIRNATY), via an unspecified route of administration, administered in right arm on 02Jun2021 09:00 (at the age of 46-year-old) as single dose for covid-19 immunisation. Medical history included kidney stone. Concomitant medications included influenza A(H1N1) pdm09 vaccine taken for H1N1 influenza immunisation on 15May2021 and nitrofurantoin. On 03Jun2021 at 20:00, the patient experienced fever between 37 to 39 degrees, headache, pain in eyes, body pain, chills, body strengthless, no appetite, pain in arm, cough, chest pain. Seriousness Criteria for events was disability or permanent damage. No treatment was received for the adverse events. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient was not pregnant. The outcome of the events was not recovered. Information on the lot/batch number has been requested.

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