National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1367871

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1367871
VAERS Form:2
Age:34.0
Sex:Male
Location:California
Vaccinated:2021-06-01
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Abdominal pain upper, Dizziness, Flushing, Hyperhidrosis

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Stomach aches-Mild, Systemic: Flushed / Sweating-Medium, Additional Details: Pt started feeling lightheaded and signs of flushing at 3:05PM post-vaccination. RPh had pt lie down on the floor and continiously monitored BP and pulse. BP and pulse were 96/55; 52 and 122/74; 80 at 3:08PM and 3:17PM, respectively. Pt had no relevant PMH and attributed his lightheadness to anxiety and witnessing his partner experience vertigo post-vaccination. Pt fully recovered and left the pharmacy at 3:35PM. Pt''s temp was 95.5 F at 3:24 PM.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1367871&WAYBACKHISTORY=ON


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