VAERS ID: 908969

AGE: 48| SEX: M|STATE: IL (United States)

Description

Starting that night 12/19/20 at approx 8pm I became nauseous with a 100.8f fever. I felt achy for the 2 days with the fever subsided. On Monday 12/21/20 I was at work (Firefighter) when I started to have palpitations. I was able to obtain a 12 lead EKG right away which showed a ventricular rhythm lasting for approx 5 min. After that I was having multiple PVC's / Ventricular beats. I was taken to Hospital where I was admitted. Over night the rhythm subsided, all my labs were good with other test's being done. I was discharged home. I have not had any other episodes since Monday. I was cleared by our Occ Health Doc who suggested I fill this out.

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Symptoms

Pyrexia, Nausea, Pain, Palpitations, Electrocardiogram abnormal, Ventricular extrasystoles, Ventricular arrhythmia, Echocardiogram, Laboratory test normal, Scan myocardial perfusion

Vaccines

VAX DATE: 12-19-2020| ONSET DATE: 12-21-2020| DAYS TO ONSET: 2
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EK5730 IM LA

RECVDATE:12-24-2020
RPT_DATE:
CAGE_YR:48
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:1
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:Complete lab work Nuclear stress test Echo cardiogram Multiple EKG's
V_ADMINBY:OTH
OTHER_MEDS:Aspirin 81mg
CUR_ILL:
HISTORY:Myasthenia Gravis
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-24-2020
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:Y
ALLERGIES:Vancomycin
V_FUNDBY:

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