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This is VAERS ID 1470495

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1470495
VAERS Form:2
Age:14.0
Sex:Female
Location:Michigan
Vaccinated:2021-06-17
Onset:2021-07-01
Submitted:0000-00-00
Entered:2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Public      Purchased by: ??
Symptoms: Echocardiogram normal, Electrocardiogram normal, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin 200mg daily
Current Illness: None
Preexisting Conditions: Bicuspid Aortic Valve
Allergies: None
Diagnostic Lab Data: EKG, 2D echo performed on: 7/9/21
CDC 'Split Type':

Write-up: Unknown lot #. Syncope s/p 2 weeks from vaccination

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1470495&WAYBACKHISTORY=ON


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