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This is VAERS ID 1330755

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1330755
VAERS Form:2
Age:16.0
Sex:Male
Location:Unknown
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 EW1085 / 2 RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Anxiety, Dizziness, Hyperhidrosis, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Post vaccination pt began s/s lightheaded ness, anxious and diaphoretic. RN and I transferred patient into cot, patient had syncopal episode of 2min, paramedics on site. Vital signs stable, patient states feeling, ? a lot better? after a few minutes. Patient and mother refuse going to the hospital. AMA was signed. Patient then transferred himself into wheelchair with minimal assistance. Patient waited in observation for 30min and left home with mom.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1330755&WAYBACKHISTORY=ON


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