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This is VAERS ID 1376309

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1376309
VAERS Form:2
Age:15.0
Sex:Male
Location:New York
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 EW0180 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Flushing, Hyperhidrosis

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: Flushed / Sweating-Mild, Additional Details: EMT came to assess and escorted patient out of the pharmacy. Patient was standing up and said he was feeling fine by the time EMT came.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1376309&WAYBACKHISTORY=ON


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