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This is VAERS ID 1454513

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1454513
VAERS Form:2
Age:20.0
Sex:Female
Location:Michigan
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 (MODERNA)) / MODERNA 011D21A / 2 LA / IM

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

Write-up: Systemic: Fainting / Unresponsive-Mild, Additional Details: Pt fainted...I went across the register where she was... she was fully responsive the entire time. She mentioned that she did have very low blood pressure and anticipated that she might faint. She was responsive to all my questions and was fully cognitive. She laid down little bit with legs raised.. drank some water... Sat in the chair and was Ok the entire time. Spoke with her and she said she was ok.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1454513&WAYBACKHISTORY=ON


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