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This is VAERS ID 1763300

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1763300
VAERS Form:2
Age:12.0
Sex:Male
Location:Foreign
Vaccinated:2021-09-04
Onset:2021-09-04
Submitted:0000-00-00
Entered:2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2834 / 1 RA / OT

Administered by: Other      Purchased by: ??
Symptoms: Fatigue, Loss of consciousness

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': ITPFIZER INC202101248509

Write-up: Fainting after 1 dose of Covid-19 vaccine. After 5-10 minutes of administration. Regaining consciousness in 1-2 Min and complete in 15 minutes.; Tiredness and exhaustion for the next 2..3 days.; Tiredness and exhaustion for the next 2..3 days.; This is a spontaneous report from a contactable consumer or other non hcp downloaded from the Regulatory Agency (RA)-WEB, regulatory authority number IT-MINISAL02-788250. A 12-year-old male patient received first dose of bnt162b2 (COMIRNATY, Formulation: Solution for injection, Batch/Lot Number: FF2834) via intramuscular, administered in right shoulder on 04Sep2021 as dose 1, 0.3 mL single (at the age of 12-year-old) for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. On 04Sep2021, the patient stated fainting after first dose of Covid-19 vaccine, after 5-10 minutes of administration, regaining consciousness in 1 to 2 minutes and complete in 15 minutes, tiredness and exhaustion for the next 2 to 3 days. This events were considered medically significant. Action taken included control by personnel 118 present on the vaccination site. Impact of the quality of life was (4/10). At the time of reporting, outcome of the events were recovering. No follow-up attempts are possible. No further information is expected

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