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This is VAERS ID 1750149

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/1/2021

VAERS ID: 1750149
VAERS Form:2
Age:15.0
Sex:Female
Location:Michigan
Vaccinated:2021-09-30
Onset:2021-09-30
Submitted:0000-00-00
Entered:2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Loss of consciousness, Malaise, Seizure, Unresponsive to stimuli

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)? Yes
Hospitalized? No
Previous Vaccinations: HPV Vaccine, Patient had passed out but it was no where near as severe as described by her mother. Unknown when the exact date w
Other Medications: Aripiprazole, Sertraline, Fluoxetine, and Hydroxyzine although I believe the mother had said she had only taken fluoxetine so far today.
Current Illness: N/A
Preexisting Conditions: Anxiety and depression.
Allergies: No known drug allergies.
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: A couple minutes after getting the vaccine the patient complained she was not feeling well. We tried giving her some orange juice to see if that would make her feel better. She started to pass out dropping the orange juice and temporarily became unresponsive. She also had a few minor convulsions. 911 was called and we called a department 50 bringing in the other pharmacist and senior team members to watch over the patient while I had 911 on the line. Patient eventually regained partial consciousness and awareness answering questions. She was able to breath throughout the episode. The EMTs eventually came and got her on a cart administering oxygen and continuing to check her awareness. She was transported out of the pharmacy.

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