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This is VAERS ID 1376560

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1376560
VAERS Form:2
Age:19.0
Sex:Female
Location:Massachusetts
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 EW0196 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Anxiety, Dizziness, Flushing, Hyperhidrosis, Refusal of treatment by patient, Eye contusion

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: Flushed / Sweating-Mild, Additional Details: patient said she was prone to passing out from anxiety of getting vaccines and within 3 minutes of receiving vaccine patient said she felt like she was going to pass out and did seem to black out for a few seconds. 911 was called but patient refused treatment and was fully recovered before leaving EMT recommended patient take antiaxiety medication before receiving another vaccine

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1376560&WAYBACKHISTORY=ON


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