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This is VAERS ID 1775242

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1775242
VAERS Form:2
Age:30.0
Sex:Male
Location:New York
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 FF8841 / 1 LA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Chills, Dizziness, Erythema, Fall, Fatigue, Injection site pain, Myalgia, Nausea, Pain in extremity, Swelling, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The patient was fine for 15 minutes after taking the shot. However, After 25 minutes the patient fell on the chair and started calling for help. He was feeling dizzy and fainting. He was saying that he is feeling like throw up. He was feeling nauseous, had a sore arm, swelling, redness, and pain at injection site. Tiredness, muscle pain, and chills was also reported.

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