National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1400874

History of Changes from the VAERS Wayback Machine

First Appeared on 6/18/2021

VAERS ID: 1400874
VAERS Form:2
Age:68.0
Sex:Female
Location:New Jersey
Vaccinated:2021-06-02
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 LA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Intensive care, Ruptured cerebral aneurysm, Surgery

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? Yes, days: 12     Extended hospital stay? No
Previous Vaccinations:
Other Medications: olmsrtn-amlepn hctz 40 -5-25 mg clonieine hcl 0.1 mg
Current Illness:
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data: Surgery and in ICU for 12 days
CDC 'Split Type':

Write-up: 1 Ruptured brain aneurysm

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1400874&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166