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This is VAERS ID 902810

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First Appeared on 12/18/2020

VAERS ID: 902810
VAERS Form:2
Age:22.0
Sex:Female
Location:Idaho
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
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: Anxiety, Blood pressure increased, Dizziness, Dyspnoea, Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Altavera .15mg to .3mg PRN Nasonex PRN Proair HFA PRN
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: BP 150/100 (has been high since having COVID in June 2020), HR 150
CDC 'Split Type':

Write-up: Patient complained of feeling dizzy, anxious, shortness of breath. Did have some pain with injection. Did have mask on while waiting standard 15 minutes.

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