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 1443123



Case Details

VAERS ID: 1443123 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-17
Onset:2021-06-29
   Days after vaccination:104
Submitted: 0000-00-00
Entered: 2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Body temperature increased, COVID-19, Chills, Diarrhoea, Malaise, Pain, SARS-CoV-2 test positive
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 6/29: SARS-CoV2 Rapid Antigen Positive * (A) 6/29: SARS-CoV-2 RNA Positive * (A)
CDC Split Type:

Write-up: 6/29/21: 2 days of diffuse generalized abdominal pain, nonbloody diarrhea, increased general malaise and weakness. Patient feels chills but no measured fever at home. 7/1: Temp in ED 38.5. She uses 4L of O2 at night baseline but since her COVID Dx has been using 3L in the day as well. admitted to hospital 7/1/21.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1443123


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