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This is VAERS ID 1368007

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1368007
VAERS Form:2
Age:20.0
Sex:Male
Location:Wisconsin
Vaccinated:2021-06-02
Onset:2021-06-02
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Hyperhidrosis, Loss of consciousness, Nervousness

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: Patient slumped over in waiting chair shortly after vaccination. Felt like he was going to pass out he said, he got really sweaty and a little shaky. He slumped over twice for about 3 seconds each time, but he was easily woken up and was able to tell me his name. His symptoms lasted about 15 minutes after his vaccination. He drank some water and had some candy. He felt much improved.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1368007&WAYBACKHISTORY=ON


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