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This is VAERS ID 1734208

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First Appeared on 10/1/2021

VAERS ID: 1734208
VAERS Form:2
Age:41.0
Sex:Female
Location:New Jersey
Vaccinated:2021-08-26
Onset:2021-09-06
Submitted:0000-00-00
Entered:2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Pain in extremity, Illness, COVID-19, SARS-CoV-2 test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OZEMPIC
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210826; Test Name: Covid 19 test; Test Result: Negative ; Test Date: 20210909; Test Name: Covid 19 test; Test Result: Positive ; Test Date: 20210917; Test Name: Covid 19 test (Nasal Swab); Test Result: Negative
CDC 'Split Type': USPFIZER INC202101233837

Write-up: made her arm sore; symptoms of covid -19/tested positive for covid-19; I believe the Pfizer vaccine got me and my 12 year old daughter sick.; This is a spontaneous report from a contactable consumer reported for herself and her daughter, this case is for herself. A 41-year-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration on 26Aug2021 14:30 (Batch/Lot number was not reported) as DOSE 1, SINGLE for covid-19 immunisation at age of 41 years old. Medical history was none. Concomitant medication included semaglutide (OZEMPIC) taken for an unspecified indication, start and stop date were not reported. The patient reported that that prior to her first covid Pfizer shot on 26Aug2021, she had a negative covid test. Prior to vaccination, the patient was not diagnosed with COVID-19. The shot made her arm sore on 06Sep2021 at 12: 00, and on 06Sep2021 she started to get symptoms of covid -19. She tested positive for covid-19 on 09Sep2021. She believed the Pfizer vaccine got her and her 12 years old daughter sick. The events were serious per life threatening and required physician office visit. No treatment received for the events. The patient underwent lab tests and procedures which included Covid 19 test (Nasal Swab): negative on 17Sep2021. The outcome of the events was resolving. The lot number for the vaccine, [BNT162B2], was not provided and will be requested during follow up.

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