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This is VAERS ID 911281

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 911281
VAERS Form:2
Age:
Sex:Unknown
Location:Unknown
Vaccinated:2020-12-01
Onset:2020-12-01
Submitted:0000-00-00
Entered:2020-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH AK 5730, EG 168 / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Anaphylactic reaction

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 INC2020505821

Write-up: anaphylaxis; This is a spontaneous report from a non-contactable consumer. This consumer reported similar events for six patients. This is the second of six reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot number: AK 5730, EG 1685), via an unspecified route of administration in Dec2020 at a single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced anaphylaxis in Dec2020. The clinical outcome of anaphylaxis was unknown. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2020505820 different patient/same drug/event


Changed on 5/7/2021

VAERS ID: 911281 Before After
VAERS Form:2
Age:
Sex:Unknown
Location:Unknown
Vaccinated:2020-12-01
Onset:2020-12-01
Submitted:0000-00-00
Entered:2020-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH AK 5730, EG 168 / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Anaphylactic reaction

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 INC2020505821

Write-up: anaphylaxis; This is a spontaneous report from a non-contactable consumer. This consumer reported similar events for six patients. This is the second of six reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot number: AK 5730, EG 1685), via an unspecified route of administration in Dec2020 at a single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced anaphylaxis in Dec2020. The clinical outcome of anaphylaxis was unknown. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2020505820 different patient/same drug/event


Changed on 5/14/2021

VAERS ID: 911281 Before After
VAERS Form:2
Age:
Sex:Unknown
Location:Unknown
Vaccinated:2020-12-01
Onset:2020-12-01
Submitted:0000-00-00
Entered:2020-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH AK 5730, EG 168 / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Anaphylactic reaction

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 INC2020505821

Write-up: anaphylaxis; This is a spontaneous report from a non-contactable consumer. This consumer reported similar events for six patients. This is the second of six reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot number: AK 5730, EG 1685), via an unspecified route of administration in Dec2020 at a single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced anaphylaxis in Dec2020. The clinical outcome of anaphylaxis was unknown. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Linked Report(s) : US-PFIZER INC-2020505820 different patient/same drug/event

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=911281&WAYBACKHISTORY=ON


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