National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1310770

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1310770
VAERS Form:2
Age:18.0
Sex:Male
Location:Unknown
Vaccinated:2021-05-04
Onset:2021-05-04
Submitted:0000-00-00
Entered:2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EW0167 / UNK LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Hyperhidrosis, Pallor, Presyncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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':

Write-up: At clinic for first pfizer dose became pale and diaphoretic vaso vagel . Assisted to stretcher Legs elevated. Ice pack applied Seen by Dr . BP 102/60 Observed x 30 min then d/ c home with parents.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1310770&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166