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This is VAERS ID 1463342

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1463342
VAERS Form:2
Age:
Sex:Female
Location:Unknown
Vaccinated:2021-06-29
Onset:2021-07-01
Submitted:0000-00-00
Entered:2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / -

Administered by: Unknown      Purchased by: ??
Symptoms: Hypersensitivity, Rash

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC2021828873

Write-up: Severe Allergic Reaction; Developed a Severe Rash; Severe Allergic Reaction; Developed a Severe Rash; This is a spontaneous report from a contactable consumer (patient). A 58-year-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection; Lot number: FA6780) via an unspecified route of administration in left arm on 29Jun2021 as dose 2 single for COVID-19 immunization. Patient had no medical history and was not taking any other Products. Concomitant medications of the patient were not reported. Patient previously received historical first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection; Lot number: ER8735) via an unspecified route of administration on 08Jun2021 as dose 1st single for COVID-19 immunization. On 01Jul2021, 48 hours after receiving second dose of vaccination, patient experienced severe allergic reaction; developed a severe rash. Patient received treatment with Antihistamine. Outcome of the event not recovered/not resolved. Follow-up attempts are needed. Further information is expected.

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