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This is VAERS ID 1350378

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1350378
VAERS Form:2
Age:13.0
Sex:Female
Location:Unknown
Vaccinated:2021-05-22
Onset:2021-05-22
Submitted:0000-00-00
Entered:2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Dizziness, Pallor, 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: History of similar reaction with injections and vaccine needles
Allergies:
Diagnostic Lab Data: Pulse: 49 bpm Respiration: 20 SPO2: 96% B/P 100/60
CDC 'Split Type':

Write-up: AE: light headed, dizzy, pale, fainted Tx: n/a, just food and drink Outcome: juice, crackers helped resolve AE. pt was discharged home.

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