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This is VAERS ID 1396716

History of Changes from the VAERS Wayback Machine

First Appeared on 6/18/2021

VAERS ID: 1396716
VAERS Form:2
Age:18.0
Sex:Female
Location:Texas
Vaccinated:2021-06-03
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Syncope

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

Write-up: Patient received vaccine dose #1. 15 minutes later she fainted. She passed out for no more than 2-4 minutes with no injuries. When she awoke, it took her about 1-2 minutes to become fully coherent. There were no other adverse reactions or side effects. EMT was called and upon arriving asked her some basic questions. Turns out she had not eaten all day so they determined the fainting was for this reason and had nothing to do with the vaccine.

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