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This is VAERS ID 1454163

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1454163
VAERS Form:2
Age:15.0
Sex:Male
Location:Unknown
Vaccinated:2021-06-25
Onset:2021-06-25
Submitted:0000-00-00
Entered:2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: 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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Syncope episode. Patient received 1,000 ml NS bolus

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1454163&WAYBACKHISTORY=ON


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