VAERS ID: 903112

AGE: 44| SEX: F|STATE: AR (United States)

Description

Patient felt flushed, heart racing. Had irregular rhythm. Transported to Emergency Department. Treated with epinephrine. EKG performed, having pre-ventricular contractions. Checked in to ED for further evaluation.

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Symptoms

Palpitations, Electrocardiogram abnormal, Ventricular extrasystoles, Flushing, Heart rate irregular

Vaccines

VAX DATE: 12-17-2020| ONSET DATE: 12-17-2020| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EH9899 IM LA

RECVDATE:12-17-2020
RPT_DATE:
CAGE_YR:44
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:
V_ADMINBY:WRK
OTHER_MEDS:solifenacin, fluticasone, loratadine
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-17-2020
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:codeine
V_FUNDBY:

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