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This is VAERS ID 1368894

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1368894
VAERS Form:2
Age:64.0
Sex:Male
Location:Unknown
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 EW0185 / 2 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Bradycardia, Dizziness, Hyperhidrosis, Hypotension, Pallor

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: pt states he had a similar experience 20 years ago.
Other Medications: Unknown
Current Illness: NA
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt became weak, dizzy, pale and very diaphoretic a few minutes after receiving the vaccine. When further evaluated it was found that he was hypotensive and bradycardic. His blood pressure was initially 77/42 with a pulse of 54 following the vaccine at 11:21. As patient rested and drank water he was continuously evaluated and his BP increased to 91/53 a few minutes later and then it was up to 111/40 with a pulse of 60 at 11:29. Due to his condition EMS was activated @ 11:27 and they arrived on scene at 11:36 for further evaluation and transport to a higher level of care.

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