VAERS ID: 912103

AGE: 17| SEX: F|STATE: MN (United States)

Description

Dizziness and nausea 10 minutes after injection, continued to wax and wane over approx 90 minutes. No vitals taken. Patient ambulated back to work at 1800.

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Symptoms

Dizziness, Nausea, Abnormal behaviour

Vaccines

VAX DATE: 12-28-2020| ONSET DATE: 12-28-2020| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 0 COVID19 PFIZER\BIONTECH EL0140 IM

RECVDATE:12-29-2020
RPT_DATE:
CAGE_YR:17
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:Cryselle 1 tab orally once daily Fluoxetine 20 mg orally once daily
CUR_ILL:
HISTORY:Anxiety, depression, menorrhagia, family hx of Marfan syndrome
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-29-2020
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:Amoxicillin
V_FUNDBY:

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