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This is VAERS ID 1411731

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1411731
VAERS Form:2
Age:24.0
Sex:Male
Location:Foreign
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW6126 / 1 RA / -

Administered by: Other      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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': IEPFIZER INC2021654698

Write-up: Fainted after vaccination; This is a spontaneous report from a contactable consumer (patient) received from Pfizer sponsored program. A 24-year-old male patient received first dose of BNT162B2 (COMIRNATY), via an unspecified route of administration, administered in right arm, on 04Jun2021 at 13:30 (Lot number: EW6126, at the age of 24-year-old) as single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced fainted after vaccination on 04Jun2021 13:30. There were no treatment for the event. The outcome of the event was recovered on unspecified date in Jun2021.

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