Adverse Event Reporting

VAERS ID	981582
Gender	Female
Age	63
StateCode	NH
Pharmaceutical Company	PFIZER\BIONTECH
Lot Number	EL3249
Number of vaccinations	1
Vaccinated	2021-01-21
Onset	2021-01-23
Condition	Permanent Disability

Symptoms

• Fatigue
• Mobility decreased
• Loss of consciousness
• Swelling
• Discomfort
• Thermal burn
• Burns second degree

Current Illness

n/a

Preexisting Conditions

Allergic Asthma Hypertension Pre-diabetes BMI > 40

Other Medications

Hydrodiuril 25 mg metoprolol succinate XL 25 mg Advair Diskus Decadron drops 1% Albuterol inhaler

Previous Vaccinations

Allergies

metronidazole

Laboratory Data

Write-up

Patient received her vaccine on Thursday, 1/21/21.
From then until Saturday afternoon she had been experiencing extreme fatigue.
On Sat.
around 5:00 PM she was standing at her flat-top stove cooking dinner.
A wave of very extreme fatigue came over her, so she leaned over to turn off the burner.
When she did this, she passed out leaning forward with her hand on the burner and touching the frying pan.
When she came to, she went to the couch and laid down - not realizing for 10 minutes that her hand and right breast were burned.
The resulting injuries lead to her having to see her PCP on Monday, and then a General Surgeon on Weds 1/27/21.
Injuries sustained include a second degree burn on her right breast, On the right arm, laterally above the wrist is a small superficial partially healed burn.
On the dorsal aspect of the right fifth finger there is a longitudinal burn that goes from the MCP joint to almost the tip of the finger.
She has limited range of motion due to discomfort and swelling.
The blister encompasses the entire dorsal lateral aspect of the finger.
The fourth right finger has a less extensive blistered area on the PIP joint.
The burn on the fifth finger is deep second degree.