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This is VAERS ID 1376404

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1376404
VAERS Form:2
Age:52.0
Sex:Female
Location:New York
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 AR / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Hypoaesthesia, Paraesthesia, Hypoaesthesia oral

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: Patient received shot, waited 15 minutes, felt fine and left store. She called about an hour later (3:05pm) asking about tingling that she was experiencing on the side of her body that got the shot (arm, hand, leg) -I believe it was left side. Also a numbness on her mouth/lips. I advised pt to contact her primary which advised pt to go to urgent care. At urgent care she was seen and her symptoms subsided. I called pt at 8:45pm she stated that she was feeling better, but lip was still numb.

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