Report #2884696

Received Feb 9, 2026

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: Male
Age: 79 yrs
State: CA
Recovered: Unknown
Vaccinated: Aug 10, 2021
Onset: Aug 10, 2021
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	2	EW0172	IM / RA
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	1	EW0172	IM / LA

Symptoms (8)

Cognitive disorderCoordination abnormalFailure to thriveFatigueHyperlipidaemiaHypertensionHypotensionType 2 diabetes mellitus

Symptom narrative

Reported Symptoms: 10010947:COORDINATION ABNORMAL; 10016256:FATIGUE; Narrative: Patient is an 84yo M with PMH of CKD3, mild cognitive impairment, FTT, hypotension, HLD, HTN, and T2DM who reported SE with the Pfizer COVID-19 vaccine initially on 08/10/2021. Vaccine was rechallenged on 09/03/2021 with associated worsening of symptoms. Patient and wife both reported SE for several days and patient remained weak. MD discussed reporting SE of COVID-19 vaccine to CDC. Other Relevant HX: Other: FATIGUE, COORDINATION PROBLEM