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This is VAERS ID 1749865

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/1/2021

VAERS ID: 1749865
VAERS Form:2
Age:30.0
Sex:Female
Location:Florida
Vaccinated:2021-09-29
Onset:2021-09-30
Submitted:0000-00-00
Entered:2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Asthenia, Lymphadenopathy, Muscular weakness, Pain, Pain in extremity, Paraesthesia, Tenderness, Immediate post-injection reaction

Life Threatening? No
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: None
Current Illness: 09/01/2021- allergies- took Zyrtec which resolved symptoms. Took COVID test: negative
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: observation, referral to PCP, follow up in 5-7 days. Instructed to go immediately to ER if symptoms should worsen, weakness/numbness or if her symptoms increase.
CDC 'Split Type':

Write-up: Reports immediately after IM injection of second dose of COVID vaccine, developed shooting pain into left arm/left side of collar bone. Reports she woke up this morning - noticed left supraclavical lymph node swelling and tenderness and "tingling like pins and needles" from knees extending to feet bilaterally. Reports onset of symptoms 09/30/2021 at 0530 am treatment: follow up with PCP or seek medical attention right away (ER or 911) should symptoms worsen, weakness/numbness or worsening tingling to bilateral lower extremity, shortness of breath, chest pain, or change in neurological status. will follow up with team member health care clinic in 5-7 days or sooner as needed

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