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This is VAERS ID 1367994

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1367994
VAERS Form:2
Age:64.0
Sex:Female
Location:Texas
Vaccinated:2021-06-02
Onset:2021-06-02
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Arthralgia, Dizziness, Dyspnoea, Headache, Heart rate increased, Neck pain

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: lisinopril 20 mg daily diclofenac sodium 75mg daily Levothyroxine 0.75mcg daily
Current Illness: none
Preexisting Conditions: hypertension thyroid problems
Allergies: codeine PCN
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: 11:55am-10 minutes after receiving the vaccine patient complained of "heart beating a little fast, SOB and feeling woozy". Ambulance was called. BP-115/72, pulse 88, pulse ox 99%, resp 14. 11:59am- LPN administered one 81 mg chewable aspirin per Dr''s request. BP 124/72, pulse 83, pulse ox 99%, resp 14. 11:58am-IV started with NS at KVO per RN. O2 per NC at 2L. Patient c/o neck, left shoulder and head pain. 12:10pm-81 mg chewable aspirin given per Dr''s orders. Ambulance arrived and patient transported to Hospital. Husband notified to meet patient at hospital.

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