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This is VAERS ID 1773652

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First Appeared on 10/15/2021

VAERS ID: 1773652
VAERS Form:2
Age:42.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-09-06
Onset:2021-09-06
Submitted:0000-00-00
Entered:2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Borderline personality disorder, Fatigue, Malaise, Nightmare, Suicidal ideation, Suicide attempt, Violence-related symptom, Vomiting, Cerebral disorder, Feeding disorder, Product use issue

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: IBUPROFEN
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC202101312535

Write-up: took an entire bottle of Tylenol PM. I wanted to die; emotionally unstable even suicidal; emotionally unstable even suicidal; Emotions became violently unable to control/a day where I was PURE rage; feel sick and run down; feel sick and run down; Throwing up; unable to eat; The dreams of my ex abuser I escaped are prominent in my mind and dream''s again now too; I genuinely feel the vaccine did something to my brain/chemical balance/emotional state; Other vaccine same date product: Covid-19/moderna, 06Sep2021; This is a spontaneous report from a contactable consumer (patient). A 42-year-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration, administered in Arm Right on 06Sep2021 18:00 (Batch/Lot number was not reported) as dose 1, single for COVID-19 immunization at a pharmacy; COVID-19 vaccine mrna (mrna 1273) (MODERNA COVID-19 VACCINE), via an unspecified route of administration on Arm Right on 06Sep2021 18:00 (Batch/Lot number was not reported) as dose 1, single for COVID-19 immunization at a pharmacy. Medical history was reported as none. No COVID prior to vaccination. Not tested for COVID post vaccination. No known allergies. Concomitant medication included ibuprofen taken for an unspecified indication, start and stop date were not reported. On 07Sep2021 03:00, the patient took an entire bottle of Tylenol PM reporting that "I wanted to die." At the same time, the patient became emotionally unstable even suicidal, emotions became violently unable to control, there was a day where I was pure rage, feel sick and run down, throwing up everyday for no reason, unable to eat for days, had dreams of my ex abuser I escaped are prominent in my mind and dream''s again now too and the patient genuinely feel the vaccine did something to her brain/chemical balance/emotional state. The patient added that "I know it sounds crazy but there''s no other correlation, nothing else odd happened to me. Can a shot do that to me?" The patient considered the events as life threatening and have case disability or permanent damage. The events required emergency room visit. No treatment was given for the events. It was also reported that other vaccine same date product: covid-19/Moderna on 06Sep2021. The outcome of the events was not recovered. The lot number for BNT162B2, was not provided and will be requested during follow up.

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