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This is VAERS ID 1331098

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1331098
VAERS Form:2
Age:15.0
Sex:Female
Location:New York
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 EW0176 / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: PE HR 86 SpO2 97 bp 100/52. patient AAO no neuro abnls, HR nl with no murmurs
CDC 'Split Type':

Write-up: patient tolerated initial injection well. approx 5 mins after vaccination the patient syncopized for 5 seconds while in the obs area. caught by mother. immediate recovery to normal cognition

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1331098&WAYBACKHISTORY=ON


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