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This is VAERS ID 1376307

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1376307
VAERS Form:2
Age:27.0
Sex:Male
Location:California
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Panic attack, Syncope, Unresponsive to stimuli

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: Fainting / Unresponsive-Medium, Additional Details: PAIENT GOT PANIC ATTACK AND FAINT BUT RECOVER WITH IN 3-4 M INUTES, CALLED 911, PARAMEDIC HELPED HIM

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