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This is VAERS ID 1388154

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1388154
VAERS Form:2
Age:12.0
Sex:Male
Location:Ohio
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Dizziness, Headache

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:
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccine given at 5:19 pm. After the vaccine, mom took pt and walked around the store rather than stay in the waiting area. They returned at approximately 5:45 pm, because pt was complaining of a bad headache rating pain 6/10. He denied any other symptoms. We had him sit down in the waiting area and gave him a bottle of water. He started feeling lightheaded a few minutes later and was moved to an exam room. I had him lay down on the exam table. At approx. 5:55pm, I checked his BP while he was laying down and it was 104/62. He reported feeling a little better, so I had him sit up. Rechecked BP and it was 108/70. He reported dizziness had resolved and headache was now 5/10. At some point while I was not with the pt, mom gave him some Aleve, but I don''t know what time. Mom decided to take him home at that point.

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