National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1409091

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1409091
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Blood pressure decreased, Body temperature, Oxygen saturation, Oxygen saturation decreased, Vomiting, Wheezing, Blood pressure measurement, SARS-CoV-2 test

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: Medical History/Concurrent Conditions: Asthma bronchial (was being treated); COVID-19
Diagnostic Lab Data: Test Date: 20210601; Test Name: blood pressure; Result Unstructured Data: Test Result:152/106 stable; Test Date: 20210601; Test Name: Body temperature; Result Unstructured Data: Test Result:36.0 Centigrade; Comments: before the vaccinations; Test Date: 20210601; Test Name: SpO2; Test Result: 88 %; Test Date: 202102; Test Name: COVID-19; Test Result: Positive
CDC 'Split Type': JPPFIZER INC2021645172

Write-up: SpO2 decreased (88%); wheezing; vomited up what she ate in the morning; Blood pressure decreased and could not be measured.; This is a spontaneous report from a contactable physician received from the regulatory authority. Regulatory authority report number is v21110995. The patient was 27-year old female. Body temperature before the vaccinations was 36.0 degrees Centigrade. Patient''s history according to the Vaccine Screening Questionnaire (including underlying diseases, allergies, vaccinations received or diseases developed within the last month, medications used, past adverse drug reaction history, and growth status) included Pyrexia after influenza vaccine vaccination, Asthma bronchial was being treated, and On February 2021 COVID-19 positive. On 01Jun2021 at 10:30 (the day of vaccinations), the patient received the first dose of bnt162b2(COMIRNATY Intramuscular injection, Lot number: FA2453, expiration date: 31Aug2021). And the event onset date was reported as 01Jun2021 at 10:45. Clinical course of the event was reported as follows: On 01Jun2021 at 10:30 (the day of vaccinations), vaccination performed. On 01Jun2021 at 10:45 (the day of vaccinations), the patient experienced wheezing appeared about 15 minutes after the vaccination. SpO2 decreased (88%), and the patient vomited up what she ate in the morning. Blood pressure decreased and could not be measured. Temporary use of Meptin inhalation, blood pressure recovered to 152/106, stable. The wheezing also disappeared and the patient returned home. The outcome of the events wheezing and blood pressure decreased and could not be measured was recovered on an unspecified date. The reporter assessed the causality between the event and the vaccines as unassessable.

New Search

Link To This Search Result:

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