National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1340497

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1340497
VAERS Form:2
Location:New Jersey
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown      Purchased by: ??
Symptoms: Seizure, Vomiting, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: MICARDIS
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Diagnostic Lab Data: Test Date: 20210503; Test Name: covid test, Blood test; Test Result: Negative
CDC 'Split Type': USPFIZER INC2021549815

Write-up: seizures; Vomiting; This is a spontaneous report from a contactable consumer (patient). A 63-year-old female patient received BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE), second dose via an unspecified route of administration, administered in left arm at the age of 63-year-old on 02May2021 (Lot Number: EWQ0171) as single dose for covid-19 immunisation. Medical history reported as no. There was no known allergies. Concomitant medication included telmisartan (MICARDIS) from 2021 (received within 2 weeks of vaccination). The patient previously took first dose of BNT162B2(PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in right arm on 11Apr2021 (Lot Number: ER8729) as single dose for covid-19 immunisation. The patient experienced vomiting and 3 episodes of severe seizures after 9 hours of last vaccine dose on 02May2021. The patient was taking to the hospital emergency room and ICU for treatment. The patient reported the case as non-serious. The patient didn''t receive any other vaccines within 4 weeks prior to the COVID vaccine. The was not pregnancy at time of vaccination. Prior to vaccination, the patient wasn''t diagnosed with COVID-19. Since the vaccination, the patient had been tested for COVID-19. The patient underwent lab tests and procedures which included covid test(Blood test): negative on 03May2021. Therapeutic measures were taken as a result of the events. The outcome of the events was recovered in May2021.

New Search

Link To This Search Result:

Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166