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This is VAERS ID 1329621

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1329621
VAERS Form:2
Age:67.0
Sex:Male
Location:Florida
Vaccinated:2021-05-18
Onset:2021-05-18
Submitted:0000-00-00
Entered:2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Blood pressure increased, Nervousness, Tremor, Immediate post-injection reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Met Fomin
Current Illness: n/a
Preexisting Conditions: diabetes
Allergies: n/a
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 11:35am Patient C/O hands very shaky. 11:47am Pt reported feeling much better. BP 159/102, 88. 11:47am Patient reported feeling much better. Patient was advised that if symptoms return to call 911 or urgent care. Patient verbalized understanding.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1329621&WAYBACKHISTORY=ON


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