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This is VAERS ID 1330547

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1330547
VAERS Form:2
Age:15.0
Sex:Male
Location:Maryland
Vaccinated:2021-05-19
Onset:2021-05-19
Submitted:0000-00-00
Entered:2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 RA / IM

Administered by: School      Purchased by: ??
Symptoms: Dizziness, Nausea

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 known
Current Illness: Not known
Preexisting Conditions: None known
Allergies: NKA
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Patient felt nauseous and lightheaded several minutes after receiving vaccine while sitting in chair in observation area. Was given ice pack, water, juice and snack. Taken to health suite via WC and placed on cot, supine with LEs elevated to rest for several minutes. VSS. Symptoms resolved after several minutes and patient able to go home with father.

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