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This is VAERS ID 1775786

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1775786
VAERS Form:2
Age:30.0
Sex:Male
Location:Idaho
Vaccinated:2021-10-10
Onset:2021-10-10
Submitted:0000-00-00
Entered:2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Seizure, Immediate post-injection reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Patient had a seizure 10 seconds after giving dose. Paramedics came and patient made full recovery.

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