National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1411925

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1411925
VAERS Form:2
Age:78.0
Sex:Male
Location:Foreign
Vaccinated:2021-06-03
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3661 / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Bradycardia, Dizziness, Heart rate

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210603; Test Name: Bradycardia; Result Unstructured Data: Test Result:35-40/min
CDC 'Split Type': JPPFIZER INC2021656065

Write-up: Bradycardia (35-40/min); swaying feeling; This is a spontaneous report from a contactable physician received from the Regulatory Authority (RA). Regulatory authority report number is v21111717.?? The patient was a 78-year-old male. On 03Jun2021 (the day of vaccination), the patient received?the first dose of BNT162B2 (COMIRNATY, Solution for injection, Lot number FC3661, Expiration date 30Sep2021) via an unspecified route of administration as a single dose for COVID-19 immunization. The patient experienced symptoms on 03Jun2021. The course of the event was as follows: After the vaccination, the condition was observed, the patient said that there was swaying feeling. Although the subjective symptom improved, the patient said that there was bradycardia of 35-40/min. Requested emergency transportation and sent to (a hospital). The reporting physician classified the event as serious (At risk disability) and assessed that the causality between the event and bnt162b2 as unassessable.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1411925&WAYBACKHISTORY=ON


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