This is VAERS ID 1902125

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/3/2021

Vaccin­ation / Manu­facturer (2 vaccines)	Lot / Dose	Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH	FK5127 / 1	LA / IM
FLU4: INFLUENZA (SEASONAL) (FLULAVAL QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS	E9R44 / N/A	LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Pyrexia, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: none known
Preexisting Conditions: none known
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient received both vaccines in our office on 11/22/21 and around 6pm that evening she started with fever and urticaria. Her fever got up to 102 and her parents treated it with Tylenol and Motrin rotating.

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