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This is VAERS ID 1381969

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1381969
VAERS Form:2
Age:15.0
Sex:Female
Location:Texas
Vaccinated:2021-06-02
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Dizziness, Echocardiogram, Electrocardiogram, Heart rate increased, Loss of consciousness, Pyrexia, Slow response to stimuli, Urinary incontinence, Cardiac monitoring, Blood test, Anal incontinence

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)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: EKG, Echocardiogram, Blood Work, Heart Monitor 6/4/2021
CDC 'Split Type':

Write-up: Fever the following morning. Then, 38 hours after shot: abdominal cramping, rapid heart beat, dizziness while laying in bed. Then, upon standing, passing out with loss of bowels and bladder and a tonic response.

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