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This is VAERS ID 1721147

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1721147
VAERS Form:2
Age:42.0
Sex:Female
Location:Foreign
Vaccinated:2021-09-04
Onset:2021-09-04
Submitted:0000-00-00
Entered:2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE8162 / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Body temperature, Heart rate, Heart rate decreased, Hypersensitivity, Loss of consciousness, Oxygen saturation, Presyncope, Blood pressure measurement

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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210904; Test Name: blood pressure; Result Unstructured Data: Test Result:90/60; Test Date: 20210904; Test Name: blood pressure; Result Unstructured Data: Test Result:98/60; Test Date: 20210904; Test Name: body temperature; Result Unstructured Data: Test Result:36.2 Centigrade; Comments: Before vaccination; Test Date: 20210904; Test Name: pulse rate; Result Unstructured Data: Test Result:56; Test Date: 20210904; Test Name: pulse rate; Result Unstructured Data: Test Result:60; Test Date: 20210904; Test Name: oxygen saturation; Result Unstructured Data: Test Result:99
CDC 'Split Type': JPPFIZER INC202101163963

Write-up: Loss of consciousness; Pulse rate was 56; it could be considered as Acute allergic reaction occurring; It could be considered to be Vasovagal reflex; This is a spontaneous report from a contactable physician received from the Regulatory Authority. (Regulatory Authority report number: v21125953). The patient was a 42-year-old female. The patient''s body temperature on 04Sep2021 (before vaccination) was 36.2 degrees Centigrade. There were no points to be considered on the vaccine screening questionnaire (primary diseases, allergies, vaccinations and illnesses within the last one month, medications the patient was taking, past adverse effect history, growth status). On 04Sep2021 at 11:30 (the day of vaccination), the patient received the first dose of BNT162B2 (COMIRNATY, Solution for injection, Lot number: FE8162, Expiration date: 30Nov2021) as dose 1, single, with route of administration unspecified, for COVID-19 immunization. The onset date of the events was reported as 04Sep2021 at 11:40 (10 minutes after the first dose of vaccination). On 04Sep2021 (the day of vaccination), the outcome of the events was recovered. The course of the event was as follows: On 04Sep2021 at 11:40 (10 minutes after the vaccination), the patient experienced loss of consciousness; blood pressure was 90/60; pulse rate was 56; oxygen saturation was 99, and it could be considered as acute allergic reaction occurring. The patient''s consciousness recovered immediately, and conversation also became possible. The patient rested for a while, and blood pressure was 98/60, pulse rate was 60, and it was not considered to be dyspnoea or cyanosis. It could be considered as vasovagal reflex. The patient went home on foot after resting (about 30 minutes). The reporting physician classified the events as non-serious and assessed that the events were related to BNT162B2. No follow-up attempts are needed. No further information is expected.

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