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This is VAERS ID 1685380

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/10/2021

VAERS ID: 1685380
VAERS Form:2
Age:44.0
Sex:Female
Location:Unknown
Vaccinated:2021-09-09
Onset:2021-09-09
Submitted:0000-00-00
Entered:2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2587 / 1 RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Feeling hot, Hypoaesthesia, Staring, Tremor, Reduced facial expression

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient arrived into vaccine cloinic accompanied by ex boyfriend. Patient made staff aware that she was previously hospitalized for flu vaccine in the past. Patient verbalized "pre-medicating" with Allegra PO prior to arriving at the vaccination clinic. Therefore, patient was brought to stretcher in our obsevation area to be monitored by RN''s during and after her vaccine administration. After receiving her first dose of the Pfizer vaccine in her right deltoid, patient was communicating and laughing appropriately with staff with no signs of difficulty breathing A/O x3 at this time. Patient verbalizing feeling warm. Water offered to patient. Ice Pack provided. Approximately 7 minutes after vaccine administration patient had a visibly blank stare with no facial expression. Patient''s body was then observed to start mildly shaking motion which staf then turned patient to her side. 911 called. Epinephrine 0,3mg administered as ordered per protocol to left thigh. VS taken , oxygen administered via rebreather mask at max amount. After approx. 2-3 minutes patient opened her eyes and was slowly able to respond to some questions such as her name. Patient responded appropriately. Patient stated she had some numbness on her right side. She made good eye contact. Paramedics and fire department arrived and took her via gurney to ER.

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