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This is VAERS ID 1440415

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1440415
VAERS Form:2
Age:14.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-06-29
Onset:2021-06-29
Submitted:0000-00-00
Entered:2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Feeling hot, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 6/29/21: BP: 110/71 Pulse: 101
CDC 'Split Type':

Write-up: Pt was given shot by immunizing technician. And then sat down by her parent in the waiting area. Immunizing tech came and got me since parent was worried. Pt briefly passed out. By the time I got out into the waiting area pt had already woken up. Pt felt hot got her water and checked blood pressure and pule all within normal range. Stayed with pt who after a few minutes said was feeling better. Did not call 911 due to quick recovery. Pt was kept for observation for an additional 20 minutes. Saw further improvement and pt continued to say she feels a lot better. Told pt and mother (mother did not speak English) that they should contact primary care provider about the event and further discuss if she should receive second dose or not. Due to quick recovery, believe patient most likely was nervous and worked herself up before getting the vaccination causing her to pass out.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1440415&WAYBACKHISTORY=ON

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