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This is VAERS ID 1368403

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1368403
VAERS Form:2
Age:23.0
Sex:Unknown
Location:New York
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 EW0191 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Tremor

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: norethindrone, fluoxetine, androderm, lamotrigine
Current Illness: n/a
Preexisting Conditions: asthma
Allergies: n/a
Diagnostic Lab Data: emt took blood pressure
CDC 'Split Type':

Write-up: patient was shaking with seizure-like movements, never lost consciousness, felt light-headed and dizzy, gave a cold compress then patient became ill, 911 was called, patient was evaluated and refused transport, this all happened over a 30 minute period

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