Adverse Event Reporting

VAERS ID 913469
Gender Female
Age 67
StateCode NY
Pharmaceutical Company PFIZER\BIONTECH
Lot Number EK9231
Number of vaccinations 1
Vaccinated 2020-12-23
Onset 2020-12-23
Condition Permanent Disability Recovered
  • Arthralgia
  • Pyrexia
  • Chills
  • Dyspnoea
  • Blood test
  • Urticaria
  • SARS-CoV-2 test
  • Chest X-ray
  • Electrocardiogram

Current Illness


Preexisting Conditions

I was diagnosed with with COVID 19 in April 2020 and was diagnosed with pulmonary embolus , pneumonia sob. I had no other medical conditions prior to having COVID 19.

Other Medications


Previous Vaccinations


IV contrast dye

Laboratory Data

Blood test, chest X-ray and CoVID pcr test was done EKG 12/25/2020


Shortness of breath Hives, Fever, chills joint pains.
I was Tx in the ER with Pepcid IV Solumedrol IV, Benadryl IV ,Tylenol and IV fluids.
I was discharged on prednisone , Benadryl and Tylenol.