VAERS ID: 930628

AGE: 50| SEX: F|STATE: OR (United States)

Description

Had altered mental status after vaccination. Potassium was low at 2.6; Lactate elevated at 5.7. Head CT was normal. PMHx: Diverticulitis and GERD. She has history of Airway constriction and Hives with lo dose aspirin

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Symptoms

Confusional state, Computerised tomogram head

Vaccines

VAX DATE: 12-28-2020| ONSET DATE: 12-28-2020| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EK9231 IM LA

RECVDATE:01-08-2021
RPT_DATE:
CAGE_YR:50
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:None known
CUR_ILL:
HISTORY:? GERD (gastroesophageal reflux disease) ? Diverticulitis
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:01-08-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:? Covid-19 Vacc,Mrna(Pfizer)(Pf) Anaphylaxis ? Asprin Ec Low Dose [Aspirin] Airway Constriction and Hives
V_FUNDBY:

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