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This is VAERS ID 1261751

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1261751
VAERS Form:2
Age:35.0
Sex:Female
Location:Texas
Vaccinated:2021-04-11
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / UNK RA / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Syncope

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC2021401851

Write-up: syncope two hours after the vaccine.; This is a spontaneous report from a contactable other hcp (patient). A 35-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; Batch/Lot Number: ew0151), via an unspecified route of administration, administered in Arm Right on 11Apr2021 13:00 (at 35-year-old) as single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. Patient was not pregnant. Vaccination facility type was Pharmacy or Drug Store. Patient had no covid prior vaccination. Patient was not tested for covid post vaccination. Patient had no known allergies. The patient experienced syncope two hours after the vaccine on 11Apr2021 15:00, she never had any history of syncope before. No treatment was received. The outcome of the event was recovered in Apr2021.


Changed on 5/7/2021

VAERS ID: 1261751 Before After
VAERS Form:2
Age:35.0
Sex:Female
Location:Texas
Vaccinated:2021-04-11
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / UNK RA / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Syncope

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC2021401851

Write-up: syncope two hours after the vaccine.; This is a spontaneous report from a contactable other hcp (patient). A 35-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; Batch/Lot Number: ew0151), via an unspecified route of administration, administered in Arm Right on 11Apr2021 13:00 (at 35-year-old) as single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. Patient was not pregnant. Vaccination facility type was Pharmacy or Drug Store. Patient had no covid prior vaccination. Patient was not tested for covid post vaccination. Patient had no known allergies. The patient experienced syncope two hours after the vaccine on 11Apr2021 15:00, she never had any history of syncope before. No treatment was received. The outcome of the event was recovered in Apr2021.


Changed on 5/14/2021

VAERS ID: 1261751 Before After
VAERS Form:2
Age:35.0
Sex:Female
Location:Texas
Vaccinated:2021-04-11
Onset:2021-04-11
Submitted:0000-00-00
Entered:2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / UNK RA / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Syncope

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC2021401851

Write-up: syncope two hours after the vaccine.; This is a spontaneous report from a contactable other hcp (patient). A 35-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; Batch/Lot Number: ew0151), via an unspecified route of administration, administered in Arm Right on 11Apr2021 13:00 (at 35-year-old) as single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. Patient was not pregnant. Vaccination facility type was Pharmacy or Drug Store. Patient had no covid prior vaccination. Patient was not tested for covid post vaccination. Patient had no known allergies. The patient experienced syncope two hours after the vaccine on 11Apr2021 15:00, she never had any history of syncope before. No treatment was received. The outcome of the event was recovered in Apr2021.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1261751&WAYBACKHISTORY=ON


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