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This is VAERS ID 1370000

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1370000
VAERS Form:2
Age:51.0
Sex:Female
Location:California
Vaccinated:2021-06-01
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EWO186 / UNK LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Dizziness, Feeling hot, Throat irritation, Vomiting

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: Anaphylaxis to flu vaccination 14 years ago
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On June 1, 2021 at approximately 1500 hours, patient received the Pfizer-BioNTech) vaccination. At approximately 1517 hours, the attendee abruptly left the observation area quickly moving toward the restroom. Registered Nurse observed this reaction and immediately followed behind the attendee to the restroom. The attendee vomitted a small amount of fluid at this time and was escorted back to the observation area. At approximately 1520 hours, vitals signs were taken with the result of BP:128/78, HR 90, SPO2 99, Temp 97.9. At approximately 1525 hours, the attendee reported an itchy sensation on the left side of her throat and subjective symptoms dizziness and warmth. The attendee was administered 50 mg of Benadryl at this time and instant ice packs were applied to the back of the neck. Symptoms resolved within minutes and the patient was released home with instructions about adverse effects and when to seek medical attention.

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