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This is VAERS ID 1459454

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1459454
VAERS Form:2
Age:16.0
Sex:Male
Location:Oklahoma
Vaccinated:2021-07-03
Onset:2021-07-03
Submitted:0000-00-00
Entered:2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Confusional state, Dizziness, Injection site pain, Nausea, Syncope, Tremor, Unresponsive to stimuli

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Site: Pain at Injection Site-Mild, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Nausea-Medium, Systemic: Shakiness-Mild

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