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This is VAERS ID 902464

History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 902464
VAERS Form:2
Age:42.0
Sex:Male
Location:Louisiana
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Electrocardiogram normal, Hyperhidrosis, Presyncope, Laboratory test normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Basic Chemistry, EKG, and vitals were all normal on 12/15/2020.
CDC 'Split Type':

Write-up: within 15 minutes progressive light-headedness leading to near-syncope and diaphoresis. After 20 minutes symptoms subsided.


Changed on 12/24/2020

VAERS ID: 902464 Before After
VAERS Form:2
Age:42.0
Sex:Male
Location:Louisiana
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Electrocardiogram normal, Hyperhidrosis, Presyncope, Laboratory test normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: Basic Chemistry, EKG, and vitals were all normal on 12/15/2020.
CDC 'Split Type':

Write-up: within 15 minutes progressive light-headedness leading to near-syncope and diaphoresis. After 20 minutes symptoms subsided.


Changed on 12/30/2020

VAERS ID: 902464 Before After
VAERS Form:2
Age:42.0
Sex:Male
Location:Louisiana
Vaccinated:2020-12-15
Onset:2020-12-15
Submitted:0000-00-00
Entered:2020-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Electrocardiogram normal, Hyperhidrosis, Presyncope, Laboratory test normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: Basic Chemistry, EKG, and vitals were all normal on 12/15/2020.
CDC 'Split Type':

Write-up: within 15 minutes progressive light-headedness leading to near-syncope and diaphoresis. After 20 minutes symptoms subsided.

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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=902464&WAYBACKHISTORY=ON


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