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This is VAERS ID 1330996

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1330996
VAERS Form:2
Age:13.0
Sex:Female
Location:Texas
Vaccinated:2021-05-15
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 EW0175 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Crying, Headache, Pain, Visual impairment

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: Syncope after HPV vaccine. Age 11 years. 2018.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient developed changes in her vision that she reported as black dots on the left side of her vision that lasted roughly 2 minutes. She said she could not see out to the left side of her eye. This went away after 2 minutes and within 20-30 minutes she developed a severe headache and was in tears from the pain. She has no history of headaches and this has never happened before. She did not report light or sound sensitivity. She did not have any vomiting, but did not want to eat. We consulted her Optometrist and Pediatrician. I gave her Naproxen and caffeine and within 3 hours her headache resolved.

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