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This is VAERS ID 911392

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 911392
VAERS Form:2
Age:
Sex:Unknown
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2020-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 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 INC2020507515

Write-up: anaphylactic reaction; This is a spontaneous report from a contactable physician via a sales representative. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot/batch number and expiration date not provided), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced an anaphylactic reaction 8 hours after receiving the Covid-19 vaccine. The outcome of the event was unknown. Information about Batch/Lot number has been requested.; Sender''s Comments: Based on the compatible temporal association and the drug''s known safety profile, the Company considers the anaphylactic reaction is possibly related to BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) vaccination. 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: 911392 Before After
VAERS Form:2
Age:
Sex:Unknown
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2020-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 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 INC2020507515

Write-up: anaphylactic reaction; This is a spontaneous report from a contactable physician via a sales representative. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot/batch number and expiration date not provided), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced an anaphylactic reaction 8 hours after receiving the Covid-19 vaccine. The outcome of the event was unknown. Information about Batch/Lot number has been requested.; Sender''s Comments: Based on the compatible temporal association and the drug''s known safety profile, the Company considers the anaphylactic reaction is possibly related to BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) vaccination. 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: 911392 Before After
VAERS Form:2
Age:
Sex:Unknown
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2020-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 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 INC2020507515

Write-up: anaphylactic reaction; This is a spontaneous report from a contactable physician via a sales representative. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot/batch number and expiration date not provided), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced an anaphylactic reaction 8 hours after receiving the Covid-19 vaccine. The outcome of the event was unknown. Information about Batch/Lot number has been requested.; Sender''s Comments: Based on the compatible temporal association and the drug''s known safety profile, the Company considers the anaphylactic reaction is possibly related to BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) vaccination. 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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