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This is VAERS ID 1454218

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1454218
VAERS Form:2
Age:17.0
Sex:Female
Location:Illinois
Vaccinated:2021-07-07
Onset:2021-07-07
Submitted:0000-00-00
Entered:2021-07-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Loss of consciousness, Vomiting

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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: NKDA
Diagnostic Lab Data: 7/7/21 @ 9:29am BP: 100/60 HR: 74 O2: 99%
CDC 'Split Type':

Write-up: The patient passed out about 12 minutes after receiving second dose of Pfizer covid vaccination. The patient''s mother got the attention of the monitoring nursing staff at which time the patient was alert and staff elevated patients lower limbs, checked BP, HR, pulse ox, and provided cold compresses and water for patient. After about 5 minutes patient also vomited. The patient was monitored for an additional 20 minutes at which time patient felt better and was able to walk out without assistance.

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