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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1775509

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Case Details

VAERS ID: 1775509 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-09-30
Onset:2021-10-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Chills, Disturbance in attention, Dizziness, Echocardiogram, Electrocardiogram, Electrocardiogram ambulatory, Fatigue, Full blood count, Palpitations
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prazosin,effexor
Current Illness: denies
Preexisting Conditions: ptsd
Allergies: nkda
Diagnostic Lab Data: -EKG -CBC -TSH -holter -TTE -CARDS consult
CDC Split Type:

Write-up: 42-year-old patient presented on 10/8/21 for follow-up first coronavirus vaccine complaints. Most symptoms were resolved within 3 days of getting the vaccine last Thursday include fatigue upstairs, chills, headache, dizziness, decreased concentration. one that hasn''t resolved as of his shot 8 days ago are 30 seconds to 1 minute nightly palpitations spontaneously resolve when lying in bed. Denies muscle pain, sore throat, new rash cough vision problems chest pain shortness of breath GI symptoms or loss of taste or smell.


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