VAERS ID: 912713

AGE: 70| SEX: F|STATE: CA (United States)

Description

Patient reported dizziness, weakness, in and out of consciousness, palpitation and ataxia approximately 10 minutes after vaccination. Sent to ED and diagnosed with potential cerebral mass. Palpitations has occurred more frequently in the last 4 months when she ran out of metoprolol for the treatment of SVT since her PMH retired and she has not established new care yet. Dizziness, palpitations and ataxia resolved by next AM. Follow up with outpatient Neuro and cardiology. Given prescription for metoprolol XL 75 daily.

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Symptoms

Dizziness, Asthenia, Palpitations, Ataxia, Consciousness fluctuating

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 EH9899 IM LA

RECVDATE:12-29-2020
RPT_DATE:
CAGE_YR:70
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:1
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:
V_ADMINBY:PVT
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-29-2020
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:Hydrocodone/acetaminophen (nausea/vomiting)
V_FUNDBY:

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