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This is VAERS ID 1759687

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First Appeared on 10/8/2021

VAERS ID: 1759687
VAERS Form:2
Age:73.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-09-30
Onset:2021-09-30
Submitted:0000-00-00
Entered:2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 3 RA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Injection site bruising, Injection site erythema, Extra dose administered

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: Eliquis, Flecainide, Metoprolol, Budesonide, Levothyroxine, & Trazodone (at bedtime), Prolia injection last dose May 24, 2021 OTC $gCalcium Max , Vitamin d3, Turmeric, Cosamin DS
Current Illness: None
Preexisting Conditions: AFIB, Mastectomy due to cancer, some COPD, urinary incontinence
Allergies: Droperodol$g anaphylaxis Zosin &
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: I received only the Pfizer booster vaccine at this location on 9/30/21. About 2 hours after receiving my booster shot, a rather large patch of redness appeared just below the injection site . Returned to pharmacy today 10/4/21 & showed it to vaccinator. He noticed a good-sized black & blue mark at vaccine site & said he noted same effect on another who was also on a blood thinner. I reported I was there not about the black & blue mark but rather patch of redness. He said he''d never seen that before. Recommended I file this report & he was reporting it also on his end. Redness still there but getting lighter each day. No treatment was offered nor given. I was expecting that. I just felt it should be reported.

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