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This is VAERS ID 903009

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First Appeared on 12/18/2020

VAERS ID: 903009
VAERS Form:2
Age:
Sex:Female
Location:West Virginia
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer (1 vaccine) Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Work      Purchased by: ??
Symptoms: Blood glucose normal, Chills, Cold sweat, Confusional state, Dizziness, Nausea, Visual impairment

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Heart arrhythmia medication.
Current Illness: no
Preexisting Conditions: Heart arrhythmia
Allergies: kna
Diagnostic Lab Data: Pulse ox : 97 blood sugar tested 90 after orange juice. BP130/80 p 127
CDC 'Split Type':

Write-up: Patient complained of vision disturbance confusion dizziness, chills, clammy, no trouble breathing. Nausea, Patient stated she did not have any breakfast. gave patient diphenhydramine 25 mg and EMS arrived to take her to the hospital.

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