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This is VAERS ID 1429742

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1429742
VAERS Form:2
Age:16.0
Sex:Female
Location:California
Vaccinated:2021-06-20
Onset:2021-06-20
Submitted:0000-00-00
Entered:2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Blood pressure increased, Cyanosis, Loss of consciousness, Pallor

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? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: PENICILLIN
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient lost consciousness leaning against mother slowly rolling to the ground. Patient had slight convulsions for 3-5 seconds. Patient then regained consciousness after about 5 seconds looking pale with blue lips and eyes. Upon regaining consciousness patient was told to slightly elevate head and legs for increased blood flow. Upon arrival of paramedics patient had improvement in color. Patient vitals were within normal limits aside from reported hypotension per paramedics. Handed off patient to paramedics for transport to ER for further inspection at around 11:30 am.

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