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This is VAERS ID 1375963

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1375963
VAERS Form:2
Age:13.0
Sex:Female
Location:Unknown
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 2 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Anxiety, Dizziness, 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: PROZAC 20mg daily
Current Illness: NONE REPORTED
Preexisting Conditions: NONE REPORTED
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: As client exited facility she mentioned to her mom she felt faint. Client was then eased to ground by mom, staff provided chair to elevate feet. Provider and EMS paged. VS#1 BP: 102/50, HR: 89, O2: 99%. Mom reported youth is on her period, hx of fainting at sight of needles, on Prozac 20mg daily in the AM, experienced an anxiety attack immediately proceeding her 1st Pfizer dose. Water, Gatorade and snacks provided and consumed. Client placed in seated position, VS#2 98/59, HR: 81, O2: 99%. Client responded to questions appropriately. Client denied dizziness and light headedness. Client assisted into a chair, VS#3 96/62, HR: 99, O2: 99%. Client assisted into standing position by staff, VS#4 BP: 104/52, HR: 84, O2: 9

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