VAERS ID: 904555

AGE: 63| SEX: M|STATE: NY (United States)

Description

I had no reaction following the vaccination. The next day I had very mild soreness at the injection site. The next morning (about 36 hours after the vaccination) I woke up with fatigue and a sore throat. I had breakfast and about 10 minutes later I vomited everything (projectile vomiting, no nausea or abdominal pain). An hour later I had episode of severe watery diarrhea (just one episode). Felt very weak so I decided to sit down, stumbled to a chair, and then proceeded to have a syncopal episode with about 4 minutes of seizure like activity (witnessed, I don't remember that part). Decided to go to the ER, where I had labs, EKG, CXR, head CT scan, MRI and EEG. I was admitted for 24 hour observation, all the tests were normal.

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Symptoms

Syncope, Gait disturbance, Injection site pain, Asthenia, Diarrhoea, Electroencephalogram normal, Fatigue, Memory impairment, Chest X-ray normal, Oropharyngeal pain, Blood urea normal, Electrocardiogram normal, Blood glucose normal, White blood cell count increased, Blood creatinine normal, Platelet count normal, Vomiting projectile, Blood calcium increased, Blood chloride normal, Blood potassium normal, Blood sodium normal, Carbon dioxide normal, Haematocrit normal, Haemoglobin normal, Blood magnesium normal, Blood lactic acid decreased, Seizure like phenomena, Computerised tomogram head normal, Magnetic resonance imaging brain normal

Vaccines

VAX DATE: 12-15-2020| ONSET DATE: 12-17-2020| DAYS TO ONSET: 2
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EK 5730 IM LA

RECVDATE:12-20-2020
RPT_DATE:
CAGE_YR:63
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:1
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:12/17/2020: Na+ 141, K+ 4.4, Cl 101, CO 24, BUN 13, Cr 0.82, Glucose 124, Ca 10.6, Mg 1.7 WBC 11.3, HB 18.1, Hct 52.2, Plts 173 Lactic acid 4.9 (range 0.5-2.2), repeat after hydration 1.1 CXR, CT scan of brain, MRI and E of brain, and EEG all normal
V_ADMINBY:PVT
OTHER_MEDS:Bystolic 5mg once a day Prilosec 20mg once a day One a Day multivitamins
CUR_ILL:No other illnesses at the time of vaccination or one month prior.
HISTORY:History of hypertension and GERD.
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-20-2020
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:No allergies.
V_FUNDBY:

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