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This is VAERS ID 1403232

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1403232
VAERS Form:2
Age:38.0
Sex:Male
Location:Foreign
Vaccinated:2021-05-30
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Hallucination

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:
Other Medications: L-THYROXIN [LEVOTHYROXINE SODIUM]
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021645035

Write-up: hallucination; This is a spontaneous report from a contactable consumer (patient). A 38-year-old male patient received bnt162b2 (COMIRNATY), dose 1 via an unspecified route of administration on 30May2021 (at the age of 38-year-old) as 1st dose, single dose for covid-19 immunization. The patient medical history was not reported. Concomitant medication included levothyroxine sodium (L-THYROXIN [LEVOTHYROXINE SODIUM]). The patient experienced hallucination two days after vaccination (01Jun2021). The outcome of the event was unknown. Information on the lot/batch number has been requested.

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