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This is VAERS ID 1437558

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1437558
VAERS Form:2
Age:15.0
Sex:Female
Location:California
Vaccinated:2021-06-29
Onset:2021-06-29
Submitted:0000-00-00
Entered:2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Loss of consciousness

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PATIENT WAS SCREENED FOR COVID-19 VACCINE DOSE #2. PATIENT WAS ADMINISTERED VACCINE AT 9:03 AM AND ABOUT A MINUTE AFTER RECEIVING VACCINATION THE PATIENT PASSED OUT (BLACKED OUT) FOR A BRIEF SECOND AND THEN CAME BACK. PATIENT WAS TALKING NORMALLY AND HAD NO SOB. 911 WAS NOT CALLED, PATIENT THEN STAYED IN OBSERVATION AREA FOR 20 MINTUES AND AT THAT TIME PATIENT STATED THEY WERE FEELING BETTER. BOTH MOTHER AND DAUGTHER LEFT PHARMACY AFTER THAT. I ADVISED TO SEEK MEDICAL ATTENTION IF SYMTPOMS CAME BACK.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1437558&WAYBACKHISTORY=ON


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