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This is VAERS ID 910604

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 910604
VAERS Form:2
Age:
Sex:Female
Location:Texas
Vaccinated:2020-12-19
Onset:2020-12-20
Submitted:0000-00-00
Entered:2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Abdominal pain, Anaphylactic reaction, Diarrhoea, Flushing, Hypoaesthesia, Vomiting, Haemorrhage

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC2020506236

Write-up: Developed vomiting, four to five times; Diarrhea; Abdominal pain; Slightly flushed face and minimum facial flowing; Numb ears/Numb body; Bleeding; Anaphylaxis; This is a spontaneous report from a contactable consumer. A 43-year-old female patient received bnt162b2, via an unspecified route of administration on 19Dec2020 at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced anaphylaxis on 20Dec2020. Clinical course: the patient received the COVID vaccine on 19Dec2020, and since then she had developed onset of vomiting after 3 o'' clock this morning on 20Dec2020, four to five times, numb ears, numb body. She also had diarrhea and bleeding. She had some abdominal pain and she also complained of having slightly flushed face and the minimum facial flowing. The outcome of events was unknown. Information for Lot/Batch number has been requested.; Sender''s Comments: There is a reasonable possibility that the event anaphylaxis was related to BNT162b2 based on known drug safety profile. Based on the close temporal relationship, the association between the event bleeding with BNT162b2 can not be completely excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


Changed on 5/7/2021

VAERS ID: 910604 Before After
VAERS Form:2
Age:
Sex:Female
Location:Texas
Vaccinated:2020-12-19
Onset:2020-12-20
Submitted:0000-00-00
Entered:2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Abdominal pain, Anaphylactic reaction, Diarrhoea, Flushing, Hypoaesthesia, Vomiting, Haemorrhage

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC2020506236

Write-up: Developed vomiting, four to five times; Diarrhea; Abdominal pain; Slightly flushed face and minimum facial flowing; Numb ears/Numb body; Bleeding; Anaphylaxis; This is a spontaneous report from a contactable consumer. A 43-year-old female patient received bnt162b2, via an unspecified route of administration on 19Dec2020 at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced anaphylaxis on 20Dec2020. Clinical course: the patient received the COVID vaccine on 19Dec2020, and since then she had developed onset of vomiting after 3 o'' clock this morning on 20Dec2020, four to five times, numb ears, numb body. She also had diarrhea and bleeding. She had some abdominal pain and she also complained of having slightly flushed face and the minimum facial flowing. The outcome of events was unknown. Information for Lot/Batch number has been requested.; Sender''s Comments: There is a reasonable possibility that the event anaphylaxis was related to BNT162b2 based on known drug safety profile. Based on the close temporal relationship, the association between the event bleeding with BNT162b2 can not be completely excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


Changed on 5/14/2021

VAERS ID: 910604 Before After
VAERS Form:2
Age:
Sex:Female
Location:Texas
Vaccinated:2020-12-19
Onset:2020-12-20
Submitted:0000-00-00
Entered:2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Abdominal pain, Anaphylactic reaction, Diarrhoea, Flushing, Hypoaesthesia, Vomiting, Haemorrhage

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC2020506236

Write-up: Developed vomiting, four to five times; Diarrhea; Abdominal pain; Slightly flushed face and minimum facial flowing; Numb ears/Numb body; Bleeding; Anaphylaxis; This is a spontaneous report from a contactable consumer. A 43-year-old female patient received bnt162b2, via an unspecified route of administration on 19Dec2020 at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced anaphylaxis on 20Dec2020. Clinical course: the patient received the COVID vaccine on 19Dec2020, and since then she had developed onset of vomiting after 3 o'' clock this morning on 20Dec2020, four to five times, numb ears, numb body. She also had diarrhea and bleeding. She had some abdominal pain and she also complained of having slightly flushed face and the minimum facial flowing. The outcome of events was unknown. Information for Lot/Batch number has been requested.; Sender''s Comments: There is a reasonable possibility that the event anaphylaxis was related to BNT162b2 based on known drug safety profile. Based on the close temporal relationship, the association between the event bleeding with BNT162b2 can not be completely excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.

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