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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1416120



Case Details

VAERS ID: 1416120 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET8885 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, SARS-CoV-2 test
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient has not had symptoms associated with COVID-19 Patient is not enrolled in clinical trial
Allergies:
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative
CDC Split Type: GBPFIZER INC2021657725

Write-up: Light-headed; YELLOW CARD VACCINE MONITOR This is received from a contactable consumer via the Regulatory Authority. The Regulatory Authority report number is GB-MHRA-YCVM-202106041720241730-4LW0Q, Safety Report Unique Identifier GB-MHRA-ADR 25422441. A male patient of an unspecified age received the 1st dose of bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), via an unspecified route of administration, on 04Jun2021 (Batch/Lot Number: Et8885), as single dose, for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. Patient has not had symptoms associated with COVID-19. Patient was not enrolled in clinical trial. The patient experienced light-headed (dizziness) (medically significant) on 04Jun2021 with outcome of recovering. The patient underwent lab tests and procedures which included COVID-19 virus test: negative on unknown date. No follow-up attempts are possible. No further information is expected. The reporter''s assessment of the causal relationship of the event with the suspect product was not provided at the time of this report. Since no determination has been received, the case is managed based on the company causality assessment.; Sender''s Comments: Based on the current available information and the plausible drug-event temporal association, there is a reasonable possibility that event Light-headed was related to suspect drug.


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