Vaer Report Details
Age: 30 years old
Gender: Female
State: Ohio
- Patient Died?
- No
- Vaccine information
-
Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Type: Coronavirus 2019 vaccine
Manufacturer: PFIZER
Lot: fk9729
- Date report was received
- 2022-03-04
- Date form completed
- Date Vaccinated
- 2022-02-17
- Date of Onset
- 1
- Number of days (onset date – vaccination date)
- 1
- Adverse Event Description
-
edc 6/18/22 received vaccine 2/17/22; on 2/18/22 began c/o migraine with nausea/vomiting lasting one day; on 2/19/22 began c/o right shoulder pain radiating to the back lasting one week ; was followed by ob and pcp
- Lab Data
-
na
- List of symptoms
-
back pain vomiting nausea arthralgia pain migraine maternal exposure during pregnancy
- Patient Died?
- No
- Date Died
- NA
- Birth defect
- false
- Vaccine Administered By:
- Workplace clinic
- Vaccine Purchased By:
- Unknown
- Patient visit ER?
- No
- Patient Hospitalized?
- No
- Stay in hospital
- No
- Days in hospital
- Unspecified
- Permanent disability?
- No
- Allergies:
-
na
- Current Illness
-
na