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This is VAERS ID 1347000

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1347000
VAERS Form:2
Age:12.0
Sex:Female
Location:Idaho
Vaccinated:2021-05-22
Onset:2021-05-22
Submitted:0000-00-00
Entered:2021-05-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Dizziness, Hyperhidrosis, Vital signs measurement, Breath sounds normal

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: N/A
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Complained of being light headed, diaphoretic Vital Signs: BP 108/72 HR 104 Resp 20 O2Sat 97 Skin Signs: Diaphoretic Circulation: Cap refill <1sec Respiratory: Breath sound clear bilaterally Initial Treatment: Moved patient to triage, placed her in supine with feet elevated. Offered water and snacks. 3:04 PM Vital Signs: BP 108/61 HR 108 Resp 20 O2Sat 98 Skin Signs: Warm and dry Circulation: Cap refill <1sec Respiratory: Breath sound clear bilaterally Vital Signs: BP 104/64 HR 90 Resp 18 O2Sat 98 Skin Signs: Warm and dry Circulation: Cap refill <2sec Respiratory: Breath sound clear bilaterally Notes: Patient stated she was feeling better after 10 min. Advised patient to seek medical attention if symptoms re-occur or worsen. Home with parent.

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