National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/12/2021 release of VAERS data:

This is VAERS ID 904445

Government Disclaimer on use of this data



Case Details

VAERS ID: 904445 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2020-12-18
Onset:2020-12-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2020-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bupropion XL, Pantoprazole, Docusate Sodium
Current Illness: None
Preexisting Conditions: Depression, Gastroesophageal Reflux
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Petechiae - very mild on proximal area of right thigh. Noted two days after vaccine. Appears to be resolving.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=904445


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