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This is VAERS ID 1327966

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1327966
VAERS Form:2
Age:12.0
Sex:Female
Location:Missouri
Vaccinated:2021-05-18
Onset:2021-05-18
Submitted:0000-00-00
Entered:2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Fall, Syncope, Vomiting

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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: approximately 30 seconds after patient received this vaccine she fainted and fell to the floor. She regained consciousness but then began to vomit. Symptoms were short lived and 9 hours later she seems to be fine.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1327966&WAYBACKHISTORY=ON


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