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This is VAERS ID 1330702

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1330702
VAERS Form:2
Age:17.0
Sex:Male
Location:Virginia
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 EW0185 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Fall, Hyperhidrosis, Syncope, Magnetic resonance imaging

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: Once at the doctors office
Other Medications: None
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: None reported
Diagnostic Lab Data: MRI
CDC 'Split Type':

Write-up: After patient received the vaccine, went to sit on a chair for observation, he fainted and fall on the floor. He reported to fill dizzy and sweaty. Applied cold pack in the neck area on the back. The ambulance was called and patient was taken to the hospital for further treatment.

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