VAERS ID: 902768

AGE: 42| SEX: F|STATE: TX (United States)

Description

Nausea, tremors, and decrease in HR. Patient taken to ED. No epinephrine injection administered.

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Symptoms

Nausea, Tremor, Heart rate decreased

Vaccines

VAX DATE: 12-16-2020| ONSET DATE: 12-16-2020| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EK5730 IM RA

RECVDATE:12-16-2020
RPT_DATE:
CAGE_YR:42
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:
V_ADMINBY:PVT
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-16-2020
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:Ciprofloxacin-rash Pregablin-insomnia
V_FUNDBY:

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