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This is VAERS ID 1433154

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1433154
VAERS Form:2
Age:12.0
Sex:Male
Location:Pennsylvania
Vaccinated:2021-06-26
Onset:2021-06-26
Submitted:0000-00-00
Entered:2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 - / ID

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Generalised tonic-clonic seizure, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: anxiety, allergic rhinitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: yelled out loudly when he received the vaccine but was fine immediately after. He was sitting for about 5 minutes before his mother said that he was feeling dizzy. The doctor was going to grab an ice pop for him when he fainted. was there as he was sliding off of the chair and had him in her arms. He then began to have a tonic-clonic seizure that lasted approximately 1 minute. The mother called 911. He woke up and asked what happened. The ambulance arrived and suggested that he go the hospital. The mother was on the phone with his father and he said he did not think an ER visit was necessary. The ambulance left and after waiting another 30 minutes, mom took home.

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