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From the 11/26/2021 release of VAERS data:

Found 2,293 cases where Age is 12-or-more-and-under-18 and Vaccine targets COVID-19 (COVID19) and Serious

Government Disclaimer on use of this data



Case Details

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VAERS ID: 1310248 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-11
Onset:2021-04-29
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Appendicectomy, Appendicitis, Blood test, Ultrasound scan
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Tourette?s
Allergies:
Diagnostic Lab Data: Blood work, ultrasound, appendectomy
CDC Split Type:

Write-up: Extreme stomach pain, appendicitis


VAERS ID: 1310719 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-05
Onset:2021-05-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Adenovirus test, Alanine aminotransferase increased, Aspartate aminotransferase increased, Back pain, Basophil count decreased, Basophil percentage, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatine phosphokinase MB increased, Blood creatine phosphokinase increased, Blood creatinine increased, Blood glucose normal, Blood magnesium increased, Blood phosphorus normal, Blood potassium increased, Blood sodium normal, Blood urea normal, Brain natriuretic peptide normal, C-reactive protein increased, Carbon dioxide normal, Chest pain, Computerised tomogram abdomen normal, Computerised tomogram pelvis abnormal, Computerised tomogram thorax normal, Cytomegalovirus test positive, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Enterovirus test negative, Eosinophil count decreased, Eosinophil percentage decreased, Epstein-Barr virus antibody negative, HIV antibody negative, HIV antigen negative, Haematocrit normal, Haemoglobin normal, Human metapneumovirus test, Human rhinovirus test, Immunology test, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Lymphocyte count decreased, Lymphocyte percentage decreased, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin decreased, Mean cell volume normal, Mean platelet volume increased, Monocyte count normal, Monocyte percentage, Nausea, Neutrophil count, Pain, Pain in extremity, Platelet count decreased, Protein total increased, Red blood cell count normal, Red blood cell sedimentation rate increased, Red cell distribution width normal, Serum ferritin normal, Tri-iodothyronine normal, Troponin I increased, Troponin increased, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Tumour lysis syndrome (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA, NKFA
Diagnostic Lab Data: Results for patient as of 5/12/2021 12:43 5/10/2021 16:03 C Reactive Protein: 2.3 (H) CK: 508 (H) CK MB: 22.6 (H) CK MB Relative Index: 4.4 Ferritin: 78 T3: 163 Troponin I: 11.786 (H) Sed Rate: 16 CMV IgG: Positive (A) EBV IgG: <10.0 EBV IgG Interpretation: Negative EBV IgM: <10.0 EBV IgM Interpretation: Negative EBV Nuclear Antigen: <3.0 EBV Nuclear Antigen Interpretation: Negative EBV Interp: See Comment Results for patient as of 5/12/2021 12:43 5/10/2021 16:04 Adenovirus Quant PCR (Copies/mL), Plasma: <172 Adenovirus Quant PCR (log), Plasma: <2.24 CMV Quant PCR (IU/mL), Plasma: <182 CMV Quant PCR (log), Plasma: <2.26 EBV Quant PCR (IU), Whole Blood: <261 EBV Quant PCR (log), Whole Blood: <2.42 Enterovirus PCR, Blood: Not Detected HIV Ab ELISA: Nonreactive HIV Ab/Ag Combo: Nonreactive HIV Comment: See Comment HIV Ag/Ab Screening Interpretation: Negative Results for patient as of 5/12/2021 12:43 5/10/2021 22:26 Influenza A: Not Detected Influenza B: Not Detected Resp Syncytial Virus: Not Detected Parainfluenza 1: Not Detected Parainfluenza 2: Not Detected Parainfluenza 3: Not Detected Parainfluenza 4: Not Detected Metapneumovirus: Not Detected Adenovirus: Not Detected Rhinovirus: Not Detected Results for patient as of 5/12/2021 12:43 5/11/2021 05:23 Sodium: 139 Potassium: 4.8 Chloride: 106 (H) CO2: 26 Glucose: 155 (H) BUN: 17 Creatinine: 0.88 Calcium: 8.9 Magnesium: 2.2 Phosphorus: 4.2 AST: 96 (H) ALT: 88 (H) Alkaline Phosphatase: 101 Total Bilirubin: 0.5 Albumin: 4.3 Total Protein: 10.8 (H) BType Natr Peptide (WC): 62.4 C Reactive Protein: 1.8 (H) Troponin I: 10.904 (H) WBC: 6.88 RBC: 5.15 Hemoglobin: 13.4 HCT: 42.2 MCV: 81.9 MCH: 26.0 MCHC: 31.8 RDWCV: 13.6 RDWSD: 40.1 Platelet: 149 (L) MPV: 12.9 (H) Differential Type: Auto Seg%: 84.5 (H) Lymph%: 8.6 (L) Mono%: 6.0 Eos%: 0.0 Baso%: 0.6 IG%: 0.3 IG Abs: <0.03 Neutrophil, Absolute (ANC): 5.82 Lymph Abs: 0.59 (L) Mono Abs: 0.41 Eos Abs: <0.03 (L) Baso Abs: 0.04 NRBC%: 0.0 NRBC Absolute: <0.01
CDC Split Type:

Write-up: presented to outside ED with complaints of new onset chest pain that radiated to the back and down his arms with concurrent nausea. Patient was sitting in the living room around 2030-2045 when he developed midsternal and epigastric region pain. Pain radiated to his upper middle back and down both left and right arms. There were no notable exacerbating or relieving factors. Pain was a 4-7 in severity. He was also nauseated. He was given tums by his mother without significant change in symptoms. After 45 minutes they decided to go to the ER. At ER labs were notable for elevated troponin (2-- $g15-- $g9). EKG with J-point elevation. Non-contrast CT chest/abd/pelvis was unremarkable. He was given ASA 325 and famotidine in the ED. Pain eventually subsided around 2345. He was transferred to another hospital for further evaluation of troponinemia.


VAERS ID: 1311150 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-04-23
Onset:2021-05-03
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 3 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Haematoma, Platelet count decreased, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None according to mother
Current Illness: NO
Preexisting Conditions: ASTHMA
Allergies: None
Diagnostic Lab Data: Platelets at 40,000
CDC Split Type:

Write-up: Hematomas on the body from the thrombocytopenia


VAERS ID: 1313706 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-06
Onset:2021-05-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 1 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Echocardiogram normal, Electrocardiogram normal, Fibrin D dimer increased, Magnetic resonance imaging heart, Magnetic resonance imaging normal, Troponin increased
SMQs:, Haemorrhage laboratory terms (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Family history of Factor II mutation (maternal uncle and maternal great uncle); patient''s genotype unknown
Allergies:
Diagnostic Lab Data: Elevated troponin 05/11/21 x 3; normal 05/12/21 Borderline elevated D-dimer 05/11/21; normal 05/12/21 Serial EKGs normal 05/11/21, 05/12/21 Echocardiogram normal 05/11/21 Cardiac MRI, including gadolinium enhancement, normal 05/12/21
CDC Split Type:

Write-up: Patient developed chest pain with onset 05/08/21, 3 days after receiving his second Pfizer COVID-19 vaccination (Lot EW0167) on 05/06/21; he had previously received his first Pfizer COVID-19 vaccination (Lot EW0170) on 04/15/21. Pain continued until presentation at Hospital on 05/11/21, where testing indicated possible myocarditis (see below). Symptom resolved under observation without specific treatment.


VAERS ID: 1313852 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-09
Onset:2021-05-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Echocardiogram, Electrocardiogram abnormal, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 5/12/21 troponin ECG echocardiogram
CDC Split Type:

Write-up: presented to ER for chest pain on 5/11 and 5/12, diagnosed with myopericarditis with elevated troponin level, abnormal ECG; hospitalized and treated with anti-inflammatory (Ibuprofen)


VAERS ID: 1314326 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-17
Onset:2021-05-06
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray abnormal, Chest pain, Pneumothorax
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ibuprofen, Vitamin D, MVI
Current Illness: none
Preexisting Conditions: headaches history of leukemia
Allergies: none known
Diagnostic Lab Data: labs, xray and surgery 05/11/2021 CHEST 2 VIEWS X-RAY Clinical: decrease aeration on right side in all 3 right lobes, SpO2 from 95-97%; 2nd Covid shot 5/8/2021 Procedure: Chest 2 Views. This service was furnished during a public health emergency. Additional time and supplies were utilized to accommodate the recommended safety protocols. Comparison: November 20, 2018 Findings: There is a large right pneumothorax with marked collapse of the underlying right lung and mild shift of the mediastinum to the left. Left lung is clear. Heart size is normal. No obvious displaced rib fractures identified. IMPRESSION: Large right pneumothorax with pronounced collapse of the right lung. Patient immediately sent to the emergency room for further
CDC Split Type:

Write-up: 1. Right-sided chest pain and decreased aeration on Right lung (3 lobes) The pt was imaged to rule out spontaneous pneumothorax - MBI:XRY Chest, PA and Lateral (STANDARD) IMPRESSION: Large right pneumothorax with pronounced collapse of the right lung


VAERS ID: 1314459 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-03
Onset:2021-05-08
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test normal, Colonoscopy normal, Decreased appetite, Endoscopy normal, Inflammatory bowel disease, Nausea, Peripheral swelling
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nothing
Current Illness:
Preexisting Conditions: Nothing
Allergies: Nothing
Diagnostic Lab Data: Blood exams : May 10th and May 11th. Endoscopy/Colonoscopy: May 12th.
CDC Split Type:

Write-up: Patient started swelling in the left hands on Saturday May 08th and inflammation in the bowel during Monday morning May 10th. She was not able to eat and had nausea. Patient stayed at Hospital until May 13th and got many exams as endoscopy and colonoscopy and did not find any reason for such inflammation. Also, blood exams were ok. The swelling in the hands combined with inflammation on the bowel sound suspect of reaction of Pfizer vaccine as there is no event close to this date to create abnormal effects of swelling and inflammation.


VAERS ID: 1314732 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-07
Onset:2021-05-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diagnosed with myocarditis on day of admission, found to have elevated troponin levels, currently hospitalized for observation and potential supportive care, however patient with no cardiac compromise and stable. Patient with chest pain that has resolved.


VAERS ID: 1315154 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-04
Onset:2021-05-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Activated partial thromboplastin time prolonged, Blood ethanol normal, Blood thyroid stimulating hormone normal, Chest X-ray normal, Chest pain, Computerised tomogram head normal, Disorientation, Electrocardiogram normal, Electroencephalogram normal, Fall, Fatigue, Full blood count normal, International normalised ratio increased, Malaise, Metabolic function test normal, Muscle rigidity, Muscle spasms, Nausea, Posture abnormal, Prothrombin time prolonged, Seizure like phenomena, Sleep disorder, Tremor, Troponin normal, Unresponsive to stimuli
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Dystonia (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Sertraline and Methylphenidate
Current Illness: ACL tear
Preexisting Conditions: Asthma, Depression, and ADHD
Allergies: Penicillin
Diagnostic Lab Data: EKG, CBC, PT/PTT/INR, CMP, TSH, Ethanol, Troponin, Head CT, Chest xray, Video EEG
CDC Split Type:

Write-up: Patient is a 16-year-old male patient admitted with seizure like activity. One day prior to admission patient received his second COVID vaccine, Pfizer brand. On the day of admission Patient woke at 0200 with pain in the left side of the chest, mid-axillary per patient''s description it was cramp-like pain and he was able to go back to sleep. At 0500 he got up to use the restroom and went into the kitchen. He told his mom he didn''t feel well and fell forward making a gurgling sound, arms rigid, was unresponsive, and this lasted 1.5minutes according to mom. Mom called EMS and when he awoke he stated he was nauseous. After EMS arrived it was 2-3 minutes and he did not feel well again, he stood up and head fell back, eyes open, he was shaking, and making a gurgling noise again, this episode lasted 30 seconds. Upon awaking he was disorientated for a few minutes then back to baseline, he was nauseous again and very tired. He came to the ED where EKG (pending), CBC (normal), PT/PTT/INR (slight elevation), CMP (normal), TSH (normal), Ethanol (None), Troponin (normal), Head CT (normal), and chest xray (normal) were done. He received a NS bolus was given. He was admitted to the pediatric hospitalist for further evaluation and management. This is where he had a 24hour Video EEG with normal EEG he was discharged home.


VAERS ID: 1315414 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-12
Onset:2021-05-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abnormal behaviour, Anaemia, Chest discomfort, Crying, Dyspnoea, Electrocardiogram abnormal, Fear, Feeling abnormal, Hypoaesthesia, Hypokalaemia, Laboratory test abnormal, Limb discomfort, Muscular weakness, Panic reaction, Tachycardia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none known
Preexisting Conditions: none known
Allergies: Per Medical Center hospital records, client has no known drug allergies. She does have a history of environmental allergies to pollen, dust, and cats. She also once had a reaction to a preservative in eye drops.
Diagnostic Lab Data: Labs and EKG, showed hypokalemia and anemia and tachycardia
CDC Split Type:

Write-up: Approximately 5 minutes after receiving vaccine client became quiet, clenching fists, and started crying. RN asked if she was okay, stated she was scared and that her arms felt weird and her chest was tight. RN asked some questions about her health history, she then offered a granola bar and water. Client drank some water, declined snack. Clients hand began to shake, RN offered to lay client on a cot but client declined. Her dad came to check on her, she broke down saying that her arms were numb and chest was tight. The 15 vaccine minute timer went off, client stood but legs were week. She sat down and then slid herself onto the floor. She at first went into a fetal position then laid out flat on the floor. Client began acting more panicked and frantic with short quick breaths and her hands appeared to be contracting some. Clinic team made the decision to call 911 and administer 0.50 mg epinephrine. Ambulance arrived quickly and client was taken to the Medical Center via ambulance.


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