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This is VAERS ID 1475008

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1475008
VAERS Form:2
Age:15.0
Sex:Male
Location:Ohio
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 EW0181 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Anxiety, Blindness transient, Dizziness, Pallor, Presyncope, Vomiting, Fear of injection

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: Mother claimed he typically has a fear of needles and sometimes passes out with vaccines or blood draws.
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient had a vagal response caused by an anxiety attack due to fear of needles. Technician, gave the vaccine and then immediately called me in. The mother and son were worried about the needle disappearing due to the retraction mechanism. The son was loosing color in his face and becoming dizzy. I had him sit upright, talked with him for a few minutes, gave him Benadryl as a precaution, and checked his blood pressure. He was having no difficulty breathing and blood pressure was WNL. His mother said that he has passed out with needles before and that he had not eaten today. Eventually the patient claimed to lose his sight, and within 30s passed out. He was still sitting in the chair, bent over, vomited, and then immediately came back to consciousness. The patient then said that he felt fine and wanted to leave. I talked with him and his mother for around 20 minutes, had him eat a banana, and drink a full bottle of water. After the time, he felt fine and him and his mother left.

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