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This is VAERS ID 1371206

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1371206
VAERS Form:2
Age:16.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-06-03
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Dizziness, Nausea, Feeling of body temperature change

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: Effexor, Prazosin
Current Illness:
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient experienced mild nausea and lightheadedness about 10 minutes after her shot. Some alternating warmth and cold feelings. No chills. No symptoms to suggest allergic reaction. No near syncope or syncope. Symptoms were self limiting and resolved on their own. VSS throughout her stay. no orthostasis.

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