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VAERS ID: 1713577

AGE: 12| SEX: F|State: VA

Description

Patient experienced vasovagal syncope just minutes after receiving her second Pfizer Covid-19 vaccine and the seasonal influenza vaccine together. She was standing in our vaccine waiting area and fell hitting her head on the concrete floor, but did regain consciousness immediately. Emergency services was contacted immediately and they arrived 10 to 15 minutes later. The EMT examined her and felt it was not absolutely necessary she go to the emergency room as she remained alert and responsive. We told her mother signs and symptoms of concussion to be watchful for over the next 3 to 4 days and to report to the ER if her status changes.

Symptoms

Fall, Head injury, Syncope

Vaccines

VAX DATE: 17 September 2021 | ONSET DATE: 17 September 2021 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • FLUC4
  • PFIZERBIONTECH
  • SEQIRUS
  • INC.
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
  • 2
  • N/A
  • IM
  • LA
  • RA
  • 301308A
  • 308433

RECVDATE:17 September 2021
CAGE_YR:12
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:U
LAB_DATA:none
V_ADMINBY:PHM
OTHER_MEDS:unknown
CUR_ILL:unknown
HISTORY:unknown
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:17 September 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:NKDA
V_FUNDBY:
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