VAERS ID: |
902468 (history) |
Form: |
Version 2.0 |
Age: |
59.0 |
Sex: |
Male |
Location: |
Unknown |
Vaccinated: | 2020-12-15 |
Onset: | 2020-12-15 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
2020-12-15 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / 1 |
LA / IM |
Administered by: Private Purchased by: ? Symptoms: Chest discomfort,
Chills,
Defaecation urgency,
Diarrhoea,
Dizziness,
Dyspnoea,
Feeling abnormal,
Flushing,
Presyncope SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: vaso-vagal type symptoms, similar presentation 12 hours post vaccine Other Medications: unknown Current Illness: no Preexisting Conditions: unknown Allergies: unknown Diagnostic Lab Data: Trransferred to ED CDC Split Type:
Write-up: Within 1 minute, patient complained of symptoms of lightheadedness, flushing, asked for water. Symptoms persisted, reported vagal and "spacey", vitals were 117/91, HR 67, O2 sat 99% on room air. Reported chest heaviness, shortness of breath and within 5 minutes developed rigors and urge to defecate. 911 called, repeat vital 150/89 HR 113 O2sat 97%, continues to want to defecate. 1 loose BM, transferred to ED |