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This is VAERS ID 1693615

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/17/2021

VAERS ID: 1693615
VAERS Form:2
Age:17.0
Sex:Female
Location:Colorado
Vaccinated:2021-09-12
Onset:2021-09-12
Submitted:0000-00-00
Entered:2021-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Blindness, Hypotonia, Loss of consciousness

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: Unknown, no medications on record
Current Illness: none
Preexisting Conditions: asthma
Allergies: Peanuts and pecans
Diagnostic Lab Data: checked pulse, strong and normal, supple skin at 1:18pm
CDC 'Split Type':

Write-up: 17 year old female received 2nd dose of COVID vaccine at 1:15pm, at 1:18pm mother alerted pharmacy that patient was not ok. Patient was sitting in the chair and her limbs went limp and she dropped her water bottle, she was not responding to sound or touch although her eyes were open, laid patient down on the floor with feet up and she immediately regained consciousness and was able to talk. She stated that she lost vision and was ok. Mother panicked and called 911, ambulance arrived at 1:20 and escorted the patient to the ambulance to gather more information.

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