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This is VAERS ID 1741370

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/1/2021

VAERS ID: 1741370
VAERS Form:2
Age:31.0
Sex:Male
Location:Georgia
Vaccinated:2021-09-27
Onset:2021-09-27
Submitted:0000-00-00
Entered:2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 301308A / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chills, Confusional state, Dizziness, Fatigue, Flushing, Hyperhidrosis, Injection site pain, Lethargy, Syncope

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

Write-up: Site: Pain at Injection Site-Mild, Systemic: Chills-Medium, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Medium, Additional Details: pt was waiting 15 min post shot and began feeling lightheaded and passed out/fainted. he came back to quickly and was accompanied by pharmmacist and wife until ems arrived. ems checked vitals and all were normal. he was escorted to car and declined hospital visit. checed in with wife 2 hours later and he was resting on couch and feeling better.

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