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VAERS ID: | 902468 |
VAERS Form: | 2 |
Age: | 59.0 |
Sex: | Male |
Location: | Unknown |
Vaccinated: | 2020-12-15 |
Onset: | 2020-12-15 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-15 |
Vaccination / Manufacturer (1 vaccine) | 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
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: 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
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