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This is VAERS ID 1688888

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/17/2021

VAERS ID: 1688888
VAERS Form:2
Age:12.0
Sex:Female
Location:Ohio
Vaccinated:2021-09-09
Onset:2021-09-09
Submitted:0000-00-00
Entered:2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PC3183 / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: 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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PATIENT RECEIVED SECOND DOSE OF PFIZER COVID-19 VACCINE AT APPROXIMATELY 5:00 PM . ABOUT 5 MINUTES LATER , WHILE SITTING ON THE BENCH IN FRONT OF THE PHARMACY , PATIENT EXPERIENCED A BLACKOUT FOR 5 TO 10 SECONDS . PARAMAEDICS WERE CALLED AND EVALUATED PATIENT , RELEASING HER TO FATHER''S CARE AT APPROXIMATELY 5:45 PM .

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