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This is VAERS ID 1411760

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1411760
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 PAA165994/EX653 / 1 LA / -

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 INC2021654953

Write-up: Faint post vaccination; This is a spontaneous report from a Pfizer sponsored program. A contactable consumer (patient) reported that a 24-year-old male patient received bnt162b2 (COMIRNATY, Lot# Paa165994/EX6537), dose 1 via an unknown route of administration administered at the age of 24-year-old on arm left on 04Jun2021 14:00 as 1ST DOSE, SINGLE for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced faint post vaccination on 04Jun2021 14:00 with outcome of recovered. No treatment received.

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