National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/19/2021 release of VAERS data:

This is VAERS ID 1729705

Government Disclaimer on use of this data



Case Details

VAERS ID: 1729705 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-09-11
Onset:2021-09-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF3620 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Body temperature, Pyrexia, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Fibromyalgia (Being treated for fibromyalgia at another institution, stable)
Allergies:
Diagnostic Lab Data: Test Date: 20210911; Test Name: Body temperature; Result Unstructured Data: Test Result:around 38 Centigrade; Comments: pyrexia of around 38 degrees centigrade.
CDC Split Type: JPPFIZER INC202101219093

Write-up: numerous small skin eruptions on the face and entire body/Many rashes were noted on the body; Anaphylaxis; pyrexia of around 38 degrees centigrade; This is a spontaneous report from a contactable physician received from the Regulatory Authority (RA). Regulatory authority report number is v21126891. A 50-year and 3-month-old female patient received first dose bnt162b2 (COMIRNATY; Formulation: Solution for injection; Lot Number: FF3620; Expiration Date: 30Nov2021) via an unspecified route of administration on 11Sep2021 at 13:30 (the day of vaccination, age at vaccination was 50 years old) as dose 1, single for covid-19 immunisation. Body temperature before vaccination was not provided. There were points to be considered on the vaccine screening questionnaire (primary diseases, allergies, vaccinations and illnesses within the last one month, medications the patient was taking, past adverse effect history, growth status). The patient medical history includes fibromyalgia from an unknown date and unknown if ongoing (being treated for fibromyalgia at another institution, stable). The patient''s concomitant medications were not reported. On the afternoon of 11Sep2021, unknown hour and minute (the day of vaccination), the patient experienced anaphylaxis. Patient experienced pyrexia of around 38 degrees centigrade on 11Sep2021 and numerous small skin eruptions on the face and entire body/many rashes were noted on the body on 13Sep2021. The course of the event was as follows: On 11Sep2021, at evening of the day of vaccination, the patient experienced pyrexia of around 38 degrees centigrade. The patient took LOXONIN, and the pyrexia subsided. Around 13Sep2021, however, the patient began to experience numerous small skin eruptions on the face and entire body. On 14Sep2021, the patient visited an Emergency Medical Center and was prescribed antihistamine. Without any improvement, the patient presented to clinic on 15Sep2021. Many rashes were noted on the body. The patient was followed up with oral medication. The patient underwent lab test which included body temperature around 38 centigrade on 11Sep2021. Therapeutic measures were taken as a result of anaphylaxis, pyrexia of around 38 degrees centigrade with Loxonin, numerous small skin eruptions on the face and entire body/many rashes were noted on the body with antihistamine and oral medication. The outcome of the event pyrexia was recovering; anaphylaxis was unknown and numerous small skin eruptions on the face and entire body/Many rashes were noted on the body was reported as not resolved. The reporting physician classified the events as non-serious and assessed that the event was related to bnt162b2. No follow-up attempts are possible. No further information is expected.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1729705


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