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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 903010 |
VAERS Form: | 2 |
Age: | |
Sex: | Male |
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 | LA / IM |
Administered by: Work Purchased by: ??
Symptoms: Confusional state, Slow response to stimuli, 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: yes.
Current Illness: UTI
Preexisting Conditions: yes
Allergies: kna
Diagnostic Lab Data: Pulse ox 100 no sob bp 125/67 Pulse 58
CDC 'Split Type':
Write-up: After receiving vaccine patient started complain of vision disturbance, confusion, nurses started he was slow to respond. Nurses also documented that he was acting the same way the day before due to UTI. No SOB . no signs of allergic reaction
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