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This is VAERS ID 909490

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First Appeared on 12/30/2020

VAERS ID: 909490
VAERS Form:2
Age:28.0
Sex:Female
Location:Washington
Vaccinated:2020-12-26
Onset:2020-12-26
Submitted:0000-00-00
Entered:2020-12-27
Vaccin­ation / Manu­facturer (1 vaccine) Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaemia, Dizziness, Haemoglobin decreased, Nausea, Palpitations, Sinus tachycardia

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? Yes, days: (blank)
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: pollen
Diagnostic Lab Data: Anemia - Hb 9.5 tachycardia 120s
CDC 'Split Type':

Write-up: The patient developed palpitations, lightheadedness and nausea and came to the ED and was found to have sinus tachycardia. Unclear if it is a vaccine reaction or due to anxiety or severe iron deficiency anemia.

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