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This is VAERS ID 1453746

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1453746
VAERS Form:2
Age:20.0
Sex:Female
Location:Oregon
Vaccinated:2021-06-01
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0176 / 1 LA / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Diabetes mellitus, Headache, Seizure, Thyroid function test, Drug level, Magnetic resonance imaging

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:
Allergies:
Diagnostic Lab Data: Test Name: Test for diabetes; Result Unstructured Data: Test Result:Unspecified; Test Name: Drug panel test; Result Unstructured Data: Test Result:Unspecified; Test Name: MRI; Result Unstructured Data: Test Result:Unspecified; Test Name: thyroid; Result Unstructured Data: Test Result:Unspecified
CDC 'Split Type': USPFIZER INC2021756343

Write-up: seizure/she passed out convulsing; headache; This is a spontaneous report from a contactable consumer (patient). A 20-years-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot number: EW0176 and Expiration date: unknown), via an unknown route of administration, in left arm on 01Jun2021 at 12:25 (at the age of 20-years-old) as dose 1, single for covid-19 immunisation. The patient has no medical history. The patient''s concomitant medications were not reported. She did various lab tests included drug panel test, test for diabetes, thyroid and MRI: results were not specified. On 01Jun2021, 2 minutes after receiving the vaccine, she got a bad reaction, so she mentioned that she got a seizure and she passed out convulsing and she would like to report this. She also had headache that lasted a while but when she woke up that was gone (improved). She had doctor visit afterwards, doctor recommended not to get the 2nd dose of the vaccine. She received treatment for events no other than Ibuprofen then no the dosage 2 of the 200 mg so 400 2 of them so 400. She wanted to know if the vaccination card needs to be signed off for the 2nd dose even if she is not eligible for it. Outcome of event seizure was unknown, and outcome of event headache was resolved on an unknown date in Jun2021. Follow up (22Jun2021): This is a Follow up spontaneous report from a Pfizer sponsored program COVAX US support. A contactable 20-year-old female consumer (patient) reported events information.

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