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This is VAERS ID 1486286

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1486286
VAERS Form:2
Age:42.0
Sex:Female
Location:Texas
Vaccinated:2021-06-30
Onset:2021-07-01
Submitted:0000-00-00
Entered:2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / -

Administered by: Unknown      Purchased by: ??
Symptoms: Chills, Blood urine present, Pain

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 INC2021829759

Write-up: Blood in urine; Pain in all of her body/ body ache; Chills; This is a spontaneous report from a contactable consumer or other non hcp. A 42-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/Lot Number: EW0186, Expiry Date: unknown), dose 1 via an unspecified route of adminstration, administered in Arm Left on 30Jun2021 at 12:30 (at the age of 42-years-old) as dose 1, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Family medical history relevant to AE was none. History of all previous immunization with the Pfizer vaccine was not considered as suspect. No additional vaccines administered on same date of the pfizer sus-pect. No other vaccinations was done within four weeks prior to the first administration date of the suspect vaccine. On 01Jul2021, the patient experienced blood in urine, pain in all of her body/ body ache and chills. The events did not cause Emergency Room or physician office visit. It was reported that yesterday the patient woke up with body ache, chills and blood on her urine. Today she has no longer have chills or body ache, but there is still blood in her urine and she wanted to know if it was normal. Blood in her urine is worst in the morning. When she cleans herself she can see the blood. She stated that she has been drinking a lot of water and it is about the same color now. She denied any medical conditions, medications, labs, testing or treatments relevant to events. Upon follow-up 0n 02Jul2021, vaccine information including lot number, start date, anatomical location was provided. This report is not related to a study or programme. Seriousness of the events were unspecified. NDC number of Pfizer Covid 19 Vaccine was unknown. Investigation Assessment was not provided. The patient provided her doctors name but did not provide contact information for her HCP. Vaccine was not administered at military facility. Outcome of the event blood in urine was not recovered and the outcome of the other two events were recovered on 02Jul2021.

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