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This is VAERS ID 1437385

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1437385
VAERS Form:2
Age:28.0
Sex:Male
Location:Massachusetts
Vaccinated:2021-06-30
Onset:2021-06-30
Submitted:0000-00-00
Entered:2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Blood glucose normal, Blood pressure increased, Loss of consciousness, Swollen tongue, Urinary incontinence

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: per pt chart- 1/7/2015 (22years of age at time of vaccination) pt had a seizure after receiving flu, Tdap, and HPV vaccines
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Immediately after receiving Pfizer vaccine, pt experienced loss of consciousness for approximately 3 minutes, tongue swelling, incontinence of urine. Epi pen given x1, pt regained consciousness immediately after receiving epi. Vital signs as follows: BP 144/69, HR 63, O2 100% then approx 8 minutes later BP 113/63, HR 74, O2 99%, blood sugar 101. Provider assessed pt and recommended to call an ambulance for possible seizure. Pt refused to go to hospital. After incident occurred, pt stated that he has had a reaction to vaccines in the past but was unsure which ones. Pt chart stated that patient had an adverse reaction (seizure) after receiving flu, Tdap, and HPV vaccines in 2015.

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