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This is VAERS ID 1775136

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1775136
VAERS Form:2
Age:24.0
Sex:Female
Location:Washington
Vaccinated:2021-10-09
Onset:2021-10-09
Submitted:0000-00-00
Entered:2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF3590 / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Dyspnoea

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: Type I diabetes and kidney disease
Preexisting Conditions: Type I diabetes and kidney disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: After received the shot about 5 min later patient start to have dizziness and hard time of breathing. We called the paramedics and paramedic took patient after accessment

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