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This is VAERS ID 1772786

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1772786
VAERS Form:2
Age:12.0
Sex:Male
Location:California
Vaccinated:2021-09-23
Onset:2021-10-01
Submitted:0000-00-00
Entered:2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Lymphadenopathy

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: none
Preexisting Conditions: none
Allergies: no known
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Pt received a covid vaccine on 9-23-21. Injection was at the right deltoid. Pt noted a small bump at his right bicep on 10-1-21. Unclear if it is related. Appears consistent with a small lymph node. Doubt clinically significant, but will monitor over time.

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