VAERS ID: 1881367

AGE: 81| SEX: F|STATE: AZ (United States)

Description

Patient stated pain on injection resulting in fairly large lump on her left deltoid. She did not report this to use until 11/17/2021.

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Symptoms

Injection site mass, Injection site pain

Vaccines

VAX DATE: 10-21-2021| ONSET DATE: 10-21-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 3 COVID19 PFIZER\BIONTECH FE3590 IM LA

RECVDATE:11-18-2021
RPT_DATE:
CAGE_YR:81
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:Patient went to her primary care on 11/18/20 to have them look at her deltoid. Primarycare prescribed prednisone, ibuprofen and intructed patient to apply heat.
V_ADMINBY:PHM
OTHER_MEDS:I believe ibuprofen only, ice the location
CUR_ILL:None noted.
HISTORY:Asthma, allergies, hypothyroidism, & hyperlipidemia.
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:11-18-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:U
ALLERGIES:Penicillin only.
V_FUNDBY:

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