Report #2869313

Received Oct 29, 2025

Office visitDisabled

A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex: Female
Age: 39 yrs
State: TX
Recovered: Not recovered
Vaccinated: Dec 19, 2020
Onset: Jan 1, 2021
Days to onset: 13
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	2	EK5730	IM / RA

Symptoms (3)

Antinuclear antibodyDouble stranded DNA antibodySystemic lupus erythematosus

Symptom narrative

systemic lupus erythemos

Current illness

none

Medical history

GERD, HTN

Other medications

pepcid, amlodipine, metoprolol, ambien

Allergies

lisinopril

Lab data

ANA, dsDNA 12/2021