VAERS ID: 1753043

AGE: 67| SEX: F|STATE: IN (United States)

Description

1. Mild injection site soreness lasting about 51 hours. It did not impair my functioning, from 4 hours to 51 hours after dose..2. 2. Small (2-3 cm by 8-10 cm) skin erythema near injection site, onset about 4 hours after, ending about 48 hours after dose. Neither side effect required treatment. Spontaneous resolution od both adverse events.

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Symptoms

Injection site pain, Injection site erythema, Immunisation

Vaccines

VAX DATE: 09-28-2021| ONSET DATE: 09-29-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 3 COVID19 PFIZER\BIONTECH 30155BA IM LA

RECVDATE:10-01-2021
RPT_DATE:
CAGE_YR:67
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:None required or performed.
V_ADMINBY:OTH
OTHER_MEDS:Levothyroxine 75 mcg/d, calcium carbonate 1600 mg/day, vitamin D3 90 mcg/day, flaxseed oil, 1000 mg/d, Aspirin 81 mg/d.
CUR_ILL:
HISTORY:1. Mild left body muscular weakness from remote (2002) right brain radiation. 2. Treated Hashimoto's thyroiditis (in remission) with secondary (treated) hypothyroidism
PRIOR_VAX:Severe arm swelling, erythema, pruritis from injfluenza vaccine, autumn 2020
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:10-01-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:allergic to Septra/Bactrim (sulphamethoxizole/trimethoprim)
V_FUNDBY:

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