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This is VAERS ID 1367785

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1367785
VAERS Form:2
Age:13.0
Sex:Female
Location:Texas
Vaccinated:2021-06-01
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Loss of consciousness, Paraesthesia, Seizure

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
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: Pharmacy did nothing and encouraged her to come for second dose. She will be seeking medical attention from her family doctor tomorrow to follow up.
CDC 'Split Type':

Write-up: Passed out. Seizure without shaking muscles contracted and fists clenched. Dizziness. Tingle in arms.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1367785&WAYBACKHISTORY=ON


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