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This is VAERS ID 1468371

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1468371
VAERS Form:2
Age:16.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-07-13
Onset:2021-07-13
Submitted:0000-00-00
Entered:2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Hyperhidrosis, Loss of consciousness, Skin warm, Tremor

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: None per patient''s mother
Current Illness: None per patient''s mother
Preexisting Conditions: None per patient''s mother
Allergies: None per patient''s mother
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: While completing paperwork in immunization room, patient''s mother stated she thought her daughter was starting to react to the vaccine. It appeared patient was starting to pass out so pharmacist and mother lowered her down from the chair to the floor to prevent injury. Patient''s pulse was very faint to the touch and patient was difficult to arouse. Pharmacist delegated pharmacy technician to obtain AED. Patient''s mother stated patient was beginning to shake and was becoming very hot and sweaty. 911 was dialed. No health conditions or medications were noted that would cause this reaction. Pharmacist was beginning to take BP when EMS arrived. EMS continued taking vitals. BP 100/65, HR 84, SPO2 96%. Patient started to become alert again as vitals were being taken.

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