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This is VAERS ID 1442713

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1442713
VAERS Form:2
Age:65.0
Sex:Female
Location:New York
Vaccinated:2021-06-10
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 RA / -

Administered by: Private      Purchased by: ??
Symptoms: Diarrhoea

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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC2021783113

Write-up: Diarrhea; This is a spontaneous report from a contactable consumer (patient). A 65-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in right arm on 10Jun2021 10:30 (Lot Number: EW0186; Expiration Date: Aug2021) as dose 1, single for COVID-19 immunization at the age of 65-year-old. The patient received the COVID-19 vaccine in hospital. Medical history and concomitant medications were none. No family history. The patient did not receive any vaccinations prior to COVID vaccine. The patient did not undergo any relevant tests. The patient experienced diarrhea and stated that its looks like it is water on an unspecified date of Jun2021 (reported as about 4 days ago). The event did not result in any emergency room or physician office visit. It was reported the event was persisting (not recovered). She is scheduled for the second dose on 01Jul2021.

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