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From the 7/23/2021 release of VAERS data:

This is VAERS ID 1320159



Case Details

VAERS ID: 1320159 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Hypotension, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021488822

Write-up: fainted; low blood pressure; fever; This is a spontaneous report from a non-contactable consumer (patient). A 28-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in the left arm on 01May2021 (Batch/Lot Number: Unknown) as 2nd dose, single dose (at the age of 28-years-old) for COVID-19 immunization. Medical history was not reported. The patient did not have concomitant medications: the patient did not have any other medications the patient received within 2 weeks of vaccination. The patient received the first dose of 12Apr2021 BNT162B2 for COVID-19 immunization. The patient did not receive any other vaccines within 4 weeks. On 02May2021, around 24 hours after receiving the second shot of COVID vaccine the patient fainted due to fever and low blood pressure. The patient required emergency room/department or urgent care. The patient did not receive treatment for the events. The patient was not diagnosed with COVID-19 and since the vaccination the patient has not been tested for COVID-19. The outcome of the events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


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