National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 6/4/2021 release of VAERS data:

This is VAERS ID 904258



Case Details

VAERS ID: 904258 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: California  
Vaccinated:2020-12-17
Onset:2020-12-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Disturbance in attention, Dizziness, Fatigue, Flushing, Hyperhidrosis, Memory impairment, Petechiae, Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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: 1) flushing, sweats, and dizziness 2 hours after dose #1. Resolved after about 15 minutes. 2) severe fatigue next day with poor concentration and forgetfulness 3) whole body palpable rash with redness, itching, and development of patches of petechiae


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=904258


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166