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This is VAERS ID 1474462

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1474462
VAERS Form:2
Age:17.0
Sex:Male
Location:Texas
Vaccinated:2021-07-15
Onset:2021-07-15
Submitted:0000-00-00
Entered:2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Head injury, Syncope, 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)? 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: PATIENT FAINTED A COUPLE OF MINUTES AFTER RECIEVING PFIZER VACCINE; WHILE SITTING IN THE CHAIR, HE SLID OFF & HIT HIS HEAD ON THE OPPOSITE CHAIR. DID NOT FULLY LOSE CONSCIOUSNESS. NO EPIPEN NEEDED, EMS CALLED & NORMAL VITALS. PATIENT REFUSED TREATMENT/HOSPITALIZATION.

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