| VAERS ID: |
902832 (history) |
| Form: |
Version 2.0 |
| Age: |
33.0 |
| Sex: |
Male |
| Location: |
Unknown |
| Vaccinated: | 2020-12-15 |
| Onset: | 2020-12-15 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-16 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / 1 |
RA / IM |
Administered by: Private Purchased by: ?
Symptoms: Fall,
Hyperhidrosis,
Loss of consciousness,
Malaise,
Orthostatic hypotension,
Pain,
Pyrexia,
Tinnitus
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Factor 5 leidens
Allergies: Penicillins Cephalosporins
Diagnostic Lab Data:
CDC Split Type:
Write-up: Within and hour and a half of receiving developed tinnitus in both ears lasting 6 hours. The night after receiving vaccine also developed orthostatic hypotension and started to pass out but caught myself with an assisted fall. Fever(102 F with temporal and oral thermometer) body aches/sweats/general malaise lasting close to 24 hours after receiving vaccine. Fever/aches treated with acetaminophen. |
