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From the 9/3/2021 release of VAERS data:

This is VAERS ID 1486338



Case Details

VAERS ID: 1486338 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-01-23
Onset:2021-07-03
   Days after vaccination:161
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SYNTHROID; ASA; RIBOFLAVIN; VITAMIN A + D; ZINC; MAGNESIUM; TOPAMAX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Foramen ovale patent (Verbatim: PFO); Hereditary coproporphyria (Verbatim: HCP); Hypothyroidism (Verbatim: Hypothyroid)
Allergies:
Diagnostic Lab Data: Test Date: 20210703; Test Name: PCR Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC2021870371

Write-up: On 03Jul2021, I contracted Covid, delta, variant; On 03Jul2021, I contracted Covid, delta, variant; This is a spontaneous report from a contactable nurse (Patient). A 53-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; formulation: Solution for injection, Lot Number: EL9262 and Expiry date was not reported) dose 2 via an unspecified route of administration in arm Left on 23Jan2021 09:00 (age at vaccination was 53-year-old) and dose 1 (Lot number: EL3246 and Expiry date was not reported) via an unspecified route of administration in right arm on31Dec2020 13:15 as single dose for covid-19 immunisation. The patient had no known allergies. Medical history included Hypothyroid, PFO, HCP from an unknown date and unknown if ongoing. Prior to the vaccination, the patient was not diagnosed with COVID-19. Post vaccination, the patient had tested for COVID-19. Concomitant medications in two weeks were included levothyroxine sodium (SYNTHROID), asa (ASA), riboflavin (RIBOFLAVIN), ergocalciferol, retinol (VITAMIN A + D), zinc (ZINC), magnesium (MAGNESIUM), topiramate (TOPAMAX) taken for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccines within four weeks. The patient was hospice that continues to take masking precautions, hand hygiene. On 03Jul2021 16:00 she contracted covid, variant. Due to events patient visited Emergency room/department or urgent care. Treatment received for the events was Promethazine, Albuterol inhaler, Tessalon pearls. The patient underwent lab tests and procedures which included PCR nasal Swab positive on 03Jul2021. The outcome of the event was recovering.; Sender''s Comments: Based on the information in the case report, a possible causal relationship between events Covid-19 and suspect drug BNT162B2 cannot be excluded


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