Report #2863076

Received Oct 3, 2025

A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex: Female
Age: 78 yrs
State: CA
Recovered: Recovered
Vaccinated: Sep 29, 2025
Onset: Sep 29, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	1	NDC:00069-2528-	LA

Symptoms (9)

Blood testChest X-rayChillsEchocardiogramElectrocardiogramLoss of consciousnessMyalgiaNauseaUrine analysis

Symptom narrative

Around 10:00 PM I started having the usual sore muscles chills. Then at around 3:00 Am I found myself on the bathroom floor without knowing how I got there. Then I was sitting on my couch and blacked out two more times. My son said I was non responsive. I called my primary doctor and he told me to go to the emergency room. Since I was also nauseous and couldn?t eat or drink the ER hydrated me took blood work and admitted me. Afterwards I was able to eat and the next day I was discharged Thursday October 2, 2025.

Current illness

Afib congestive heart failure kidney disease?all under control.

Medical history

As above.

Other medications

Entresto, furosemide, farxiga, lasix, ezetimbe,lipitor, metoprolol succinate, spiral stone.

Allergies

Zyrtec

Lab data

Complete work up. Blood work urine test chest x-ray echo cardio gram, ekg.