National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 1020708

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 1020708
VAERS Form:2
Age:25.0
Sex:Female
Location:Maryland
Vaccinated:2021-01-22
Onset:2021-01-22
Submitted:0000-00-00
Entered:2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Dyspnoea, Pain in extremity, Pulmonary embolism, Tachycardia

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)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Mast Cell Activation Disorder POTS
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient developed rapid onset of dyspnea, light headedness and tachycardia. Was taken to the ED where she was treated with an antihistamine and IV fluids. Symptoms resolved. 6 days after the vaccine, was having shortness of breath and left arm pain (not the arm where injection was received) and was diagnosed with a pulmonary embolism.


Changed on 5/7/2021

VAERS ID: 1020708 Before After
VAERS Form:2
Age:25.0
Sex:Female
Location:Maryland
Vaccinated:2021-01-22
Onset:2021-01-22
Submitted:0000-00-00
Entered:2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Dyspnoea, Pain in extremity, Pulmonary embolism, Tachycardia

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)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Mast Cell Activation Disorder POTS
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient developed rapid onset of dyspnea, light headedness and tachycardia. Was taken to the ED where she was treated with an antihistamine and IV fluids. Symptoms resolved. 6 days after the vaccine, was having shortness of breath and left arm pain (not the arm where injection was received) and was diagnosed with a pulmonary embolism.


Changed on 5/21/2021

VAERS ID: 1020708 Before After
VAERS Form:2
Age:25.0
Sex:Female
Location:Maryland
Vaccinated:2021-01-22
Onset:2021-01-22
Submitted:0000-00-00
Entered:2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Dyspnoea, Pain in extremity, Pulmonary embolism, Tachycardia

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)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Mast Cell Activation Disorder POTS
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient developed rapid onset of dyspnea, light headedness and tachycardia. Was taken to the ED where she was treated with an antihistamine and IV fluids. Symptoms resolved. 6 days after the vaccine, was having shortness of breath and left arm pain (not the arm where injection was received) and was diagnosed with a pulmonary embolism.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1020708&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166