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This is VAERS ID 1327983

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1327983
VAERS Form:2
Age:16.0
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 EW0173 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Loss of consciousness, Nausea, Visual impairment, Eye movement disorder

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: Unknown, but father mentioned that there may have been a similar issue before.
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Right after receiving Pfizer Covid-19 vaccine, patient began to feel queasy. I asked her whether she had eaten recently and she said she hadn?t. Her eyes rolled back and up then her head fell backward. I supported her head and her dad was checking her for awareness. I gave her a bottle of water and she drank some of it. She indicated that her vision was still not accurate. Her dad brought her a candy bar and she ate the majority of it and drank the majority of the contents of the water bottle. We gave her a few more minutes to feel comfortable then I asked whether she was ready to stand up. She was not. We gave her a bag of chips and she ate some and finished the water bottle. After a few more minutes, she stood up and was able to walk without assistance. Her father indicated that she had an incident like this before, but patient did not remember the previous incident.

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