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This is VAERS ID 1328250

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1328250
VAERS Form:2
Age:12.0
Sex:Female
Location:Virginia
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 EW0177 / 1 AR / IM

Administered by: Public      Purchased by: ??
Symptoms: Loss of consciousness, 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':

Write-up: 1808-Child waiting in observation post vaccine and experienced vasovagal with syncope. Lowered to floor and feet elevated. Regained consciousness after 10 seconds. EMS on site arrived and assumed care. Child talking and able to answer questions accurately. 1812-BP 113/69 P 104 SPo2-96% 1818-113/59 P 105 S 1822-100/57 P 99 1827-103/55 P 95 1832-109/59 P 105 1838-104/58 P 102 Standing-1842-110/52 P 96 SPO2-98 Standing-1844-108/56 P 108 SPO2-97 Mother reports child played basketball outdoors for 1.5 hours prior to arriving at clinic. Ate a popsicle since lunchtime. Child departed EMS observation and care at 1848.

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