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This is VAERS ID 1371696

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1371696
VAERS Form:2
Age:61.0
Sex:Female
Location:Texas
Vaccinated:2021-06-03
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Anxiety, Hyperventilation, Hypotension, Malaise, Paraesthesia, Syncope, Vomiting

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: Pt reported near syncope and severe anxiety with all injectable medicines/vaccines
Other Medications: None Known
Current Illness: None known
Preexisting Conditions: None known
Allergies: None reported by patient
Diagnostic Lab Data: Blood pressure 63/45 prior to EMS transport.
CDC 'Split Type':

Write-up: Pt reported severe anxiety and syncope when receiving injectable medication and blood draws. Pt was agreeable to receive vaccine and a plan was made ahead of time to administer to her in her vehicle with the seat laid flat. Upon receiving the vaccine, the pt immediately stated, " I don''t feel good" and began to hyperventilate and complaint of tingling in all extremities. Pt then vomited and an EMS crew on standby was notified to evaluate the patient. The patient was eventually transported to the ER due to near syncope and hypotension.

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