1376319

thumb
Confusional state, Dizziness, Syncope, Unresponsive to stimuli
VAERS_ID:
1376319
CATEGORY:
2021
RECVDATE:
05 June 2021
STATE:
CA
AGE_YRS:
12.00
CAGE_YR:
12
CAGE_MO:
SEX:
F
RPT_DATE:
SYMPTOM_TEXT:
Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Medium
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:
Y
VAX_DATE:
21 May 2021
ONSET_DATE:
21 May 2021
NUMDAYS:
0
LAB_DATA:
V_ADMINBY:
PHM
V_FUNDBY:
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
2
TODAYS_DATE:
05 June 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
VAX_TYPE:
COVID19
VAX_MANU:
PFIZER\BIONTECH
VAX_LOT:
EW0186
VAX_DOSE_SERIES:
1
VAX_ROUTE:
IM
VAX_SITE:
LA
VAX_NAME:
COVID19 (COVID19 (PFIZER-BIONTECH))