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This is VAERS ID 1430372

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1430372
VAERS Form:2
Age:16.0
Sex:Female
Location:Indiana
Vaccinated:2021-06-02
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW 0173 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Chest X-ray, Dehydration, Dizziness, Electrolyte imbalance, Headache, Incoherent, Loss of consciousness, Swelling face, Syncope, Urine analysis, Visual impairment, Blood test, Persistent depressive disorder

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data: Chest xray, urine, blood, and cognitive were all given. Results are available
CDC 'Split Type':

Write-up: 18 hours after the 1st vaccine shot... healthy female while in the shower....blacked out, couldn''t see, called for mother who she knew was not home, passed out, and was not coherent, felt dizzy, had a bad headache, and face was swollen, Called her doctor''s office, told them about the vaccine and the incident, they said to go to the emergency room. Went to emergency room. She had a full list of tests. Was given a saline drip, hydration unit. Level V emergency code. Name vasovagal syncope, reaction to vaccine, electrolyte abnormalities, dehydration, dysthymia

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