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This is VAERS ID 1367914

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1367914
VAERS Form:2
Age:13.0
Sex:Female
Location:Nevada
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 EW0176 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Pallor

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: Dizziness / Lightheadness-Mild, Additional Details: Vaccine given at 4:05pm. Pt''s dad reported dizziness at 4:10pm. Pt appeared pale/had pale lips, was otherwise alert & oriented. Rx called 911. EMS arrived ~10 mins later. EMS check vitals & asked pt to go to the ER, however pt was feeling better and pt''s dad refused. Pt''s dad stated he''ll take her to the ER if symptoms do not improve. Pt denied any pain, shortness of breath, palpitations, nausea/vomiting, or rash. EMS escorted pt and dad out of pharmacy.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1367914&WAYBACKHISTORY=ON

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