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This is VAERS ID 1464804

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1464804
VAERS Form:2
Age:23.0
Sex:Male
Location:California
Vaccinated:2021-07-12
Onset:2021-07-01
Submitted:0000-00-00
Entered:2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA6780 / UNK - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Loss of consciousness, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: unknown
CDC 'Split Type':

Write-up: About 5 minutes after receiving the vaccination patient fainted and was unconscious for about a minute. Patient''s eyes remained open even though he was not conscious. Patient was transported by paramedic to the emergency room

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1464804&WAYBACKHISTORY=ON


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