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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1697214



Case Details

VAERS ID: 1697214 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-14
Onset:2021-09-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Adverse reaction, Allergy to vaccine, Auscultation, Chest discomfort, Chest pain, Feeling abnormal, Feeling hot, Flushing, Pharyngeal hypoaesthesia
SMQs:, Anaphylactic reaction (narrow), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Situation 2/21/1962 Patient is here for first dose of covid vaccination Background History of hypertension Assessment Pt has completed a 60 minute-minute observation period with the following signs and symptoms of an adverse reaction: other - chest pain/pressure and throat numbness and flushing. Pfizer-BioNTech COVID-19 vaccine #1 in series administered. Action(s) taken: Other - Vital signs, MD evaluation, O2 2lnc Allergy to COVID-19 vaccine documented in Allergies activity: Yes Patient advised to discuss second dose considerations with a clinician 1339: Patient awake, alert, ambulatory, reporting mid chest pressure 8/10, and throat feeling "different," pt fanning herself and feeling hot. Denies SOB, nausea, dizziness, palpitations or any other symptoms. 1340: Pt taken to procedure. Pt is able to speak in full sentences. VS taken BP 174/106 HR 77 SpO2 97% RA RR 20. No angio edema, no rash, no reports of itching, BS clear to auscultation. Denies history of anxiety and states she has never had this pain before. Does report feeling nervous prior to getting vaccinated. Pt reports hx of HTN which she takes lisinopril 1/2 tab daily (she took today''s dose), pt did not know dosage. 1342: BP recheck 172/99 HR 80. 1346: I have called Dr., incident to for the covid vaccine clinic, and given report. Received VO to transport pt to ER via ALS, read back completed. 1350: Pt now reporting pain is traveling to abdomen and is intermittent. Dr. notified. Received VO to administer O2 2lcn and aspirin 325 mg PO x 1 now. Readback completed. 1400: Pt is agreeable to being transported to ER via ambulance. Pt also reported she had taken aspirin this morning, she did not know the dose. Dr. notified and ordered to hold aspirin 325 mg PO x 1, read back completed. Pt placed on O2 2lnc. 1411: Called to request ambulance transportation to Hospital. 1414: Pt denies any chest pain or any other symptoms. BP 157/105 HR 78 SpO2 97% RA Recommendation/Action: 1440: Paramedics have arrived. Report given. While report was being given to paramedics pt stated she started having the chest pain 5 minutes after vaccine was administered and reported it 14 minutes after vaccine administration.


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