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This is VAERS ID 1415800

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1415800
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW3143 / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Abdominal distension, Asthenia, Back pain, Dizziness, Dry mouth, Dry throat, Ear pain, Fatigue, Fluid retention, Headache, Autoscopy, SARS-CoV-2 test

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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hay fever; Smoker
Allergies:
Diagnostic Lab Data: Test Date: 20210602; Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:No - Negative
CDC 'Split Type': GBPFIZER INC2021657872

Write-up: Dry mouth; Upper back pain; Weakness; Tiredness; Dizzy spells; Low back pain; Ear ache; Water retention; Abdominal bloating; Dry throat; Headache; Out of body experience; Bloating; This is a spontaneous report from a contactable consumer received from the Regulatory Agency. The regulatory authority report number is GB-MHRA-WEBCOVID-202106042039343810-HE2KO, Safety Report Unique Identifier is GB-MHRA-ADR 25423961. A male patient of an unspecified age received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot Number: EW3143) via an unspecified route of administration at single dose on 04Jun2021 for COVID-19 immunization. Medical history included suffer from hay-fever, smoke but no previous reactions to vaccines. Concomitant medications were not reported. The patient previously took vitamin E and beclomethasone. Only supplements taken were vitamins and antihistamines in the past. Patient had not had symptoms associated with COVID-19. COVID-19 virus test on 02Jun2021 was no - negative. Patient was not enrolled in clinical trial. Patient had not tested positive for COVID-19 since having the vaccine. On 04Jun2021, patient experienced dry mouth, upper back pain, weakness, tiredness, dizzy spells, low back pain, ear ache, water retention, abdominal bloating, dry throat, headache, out of body experience and bloating. All events was considered serious as other medically important condition. The outcome of events was not recovered. No follow-up attempts are possible. No further information is expected.

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