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This is VAERS ID 1266041

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1266041
VAERS Form:2
Age:39.0
Sex:Male
Location:Maryland
Vaccinated:2021-04-04
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Computerised tomogram, Electroencephalogram, Seizure, Magnetic resonance imaging

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? No
Previous Vaccinations:
Other Medications: ADVIL [IBUPROFEN]; FLONASE [MOMETASONE FUROATE]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: CT scan; Result Unstructured Data: Test Result:Unknown result; Test Name: EEG; Result Unstructured Data: Test Result:Unknown result; Test Name: MRI; Result Unstructured Data: Test Result:Unknown result
CDC 'Split Type': USPFIZER INC2021418618

Write-up: seizure one week after second vaccine; This is a spontaneous report from a contactable consumer (patient). A 39-year-old male consumer received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 04Apr2021 at 11:00 as single dose for COVID-19 immunisation at the age of 39-year-old. Medical history was unknown and concomitant medications included ibuprofen (ADVIL), mometasone furoate (FLONASE). Historical vaccine included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 14Mar2021 for COVID-19 immunisation at the age of 39-year-old. On 11Apr2021, the patient experienced seizure; the patient was treated for the event. On unknown date, the patient underwent Computerised tomogram, Electroencephalogram, Magnetic resonance imaging (results unknown). The patient was recovering from the event. Prior to vaccination, the patient was not diagnosed with COVID-19; since the vaccination, the patient has not been tested for COVID-19. Information about lot/batch number has been requested.


Changed on 5/7/2021

VAERS ID: 1266041 Before After
VAERS Form:2
Age:39.0
Sex:Male
Location:Maryland
Vaccinated:2021-04-04
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Computerised tomogram, Electroencephalogram, Seizure, Magnetic resonance imaging

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? No
Previous Vaccinations:
Other Medications: ADVIL [IBUPROFEN]; FLONASE [MOMETASONE FUROATE]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: CT scan; Result Unstructured Data: Test Result:Unknown result; Test Name: EEG; Result Unstructured Data: Test Result:Unknown result; Test Name: MRI; Result Unstructured Data: Test Result:Unknown result
CDC 'Split Type': USPFIZER INC2021418618

Write-up: seizure one week after second vaccine; This is a spontaneous report from a contactable consumer (patient). A 39-year-old male consumer received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 04Apr2021 at 11:00 as single dose for COVID-19 immunisation at the age of 39-year-old. Medical history was unknown and concomitant medications included ibuprofen (ADVIL), mometasone furoate (FLONASE). Historical vaccine included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 14Mar2021 for COVID-19 immunisation at the age of 39-year-old. On 11Apr2021, the patient experienced seizure; the patient was treated for the event. On unknown date, the patient underwent Computerised tomogram, Electroencephalogram, Magnetic resonance imaging (results unknown). The patient was recovering from the event. Prior to vaccination, the patient was not diagnosed with COVID-19; since the vaccination, the patient has not been tested for COVID-19. Information about lot/batch number has been requested.


Changed on 5/14/2021

VAERS ID: 1266041 Before After
VAERS Form:2
Age:39.0
Sex:Male
Location:Maryland
Vaccinated:2021-04-04
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Computerised tomogram, Electroencephalogram, Seizure, Magnetic resonance imaging

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? No
Previous Vaccinations:
Other Medications: ADVIL [IBUPROFEN]; FLONASE [MOMETASONE FUROATE]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: CT scan; Result Unstructured Data: Test Result:Unknown result; Test Name: EEG; Result Unstructured Data: Test Result:Unknown result; Test Name: MRI; Result Unstructured Data: Test Result:Unknown result
CDC 'Split Type': USPFIZER INC2021418618

Write-up: seizure one week after second vaccine; This is a spontaneous report from a contactable consumer (patient). A 39-year-old male consumer received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 04Apr2021 at 11:00 as single dose for COVID-19 immunisation at the age of 39-year-old. Medical history was unknown and concomitant medications included ibuprofen (ADVIL), mometasone furoate (FLONASE). Historical vaccine included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 14Mar2021 for COVID-19 immunisation at the age of 39-year-old. On 11Apr2021, the patient experienced seizure; the patient was treated for the event. On unknown date, the patient underwent Computerised tomogram, Electroencephalogram, Magnetic resonance imaging (results unknown). The patient was recovering from the event. Prior to vaccination, the patient was not diagnosed with COVID-19; since the vaccination, the patient has not been tested for COVID-19. Information about lot/batch number has been requested.

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