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This is VAERS ID 1775860

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1775860
VAERS Form:2
Age:37.0
Sex:Female
Location:Illinois
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: Hyperventilation, Loss of consciousness

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)? No
Hospitalized? No
Previous Vaccinations: seizure to flu shot five years ago.
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: none reported
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient was hyperventilating after shot. Passed out for about a minute and came to. EMS was called BP 120/72 and hr 110. Patient refused going to hospital.

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