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VAERS ID: | 1347789 |
VAERS Form: | 2 |
Age: | 31.0 |
Sex: | Female |
Location: | North Carolina |
Vaccinated: | 2021-04-24 |
Onset: | 2021-04-29 |
Submitted: | 0000-00-00 |
Entered: | 2021-05-25 |
Vaccination / Manufacturer (2 vaccines) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | - / UNK | - / - |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | - / UNK | - / - |
Administered by: Other Purchased by: ??
Symptoms: Breast discharge, Breast feeding
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: This individual has a 2 month old infant and was breast feeding at time of administration of both Pfizer covid19 vaccines. Four days after the first vaccine, individual noticed a blood tinged clot-like spit up in infant and then dark stool from infant one day later. Two days after the second vaccine, mom noticed a blood-clot-like drainage from nipple (that individual says looked just like the blood tinged spit-up that was noticed in infant).
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