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VAERS ID: 1713582

AGE: 14| SEX: F|State: CO

Description

PT IS A MINOR, SHE ENTERED THE MVU WITH THE AUTORIZATION OF HER MOM TO RECEIVE HER SECOND DOSE OF PFIZER. AFTER ASSESSING HER PT ANSWERED ALL THE QUESTIONS ASKED, SHE ALERT AND ORIENTED X3 SHE WAS EDUCATED ON WHAT TO DO AFTER RECEIVING THE VACCINE. WHILE SHE SAT DOWN FOR OBSERVATION FOR 15 MINUTES SHE REPORTED SHE FELT DIZZY AROUND 1635. WE ASSESSED HER INSIDE THE BUS. PT IS CONSCIOUS MOM SAID SHE WANTED TO DRIVE HER TO HOSPITAL. STAFF WALKED WITH HER TO MOMS CAR

Symptoms

Dizziness

Vaccines

VAX DATE: 17 September 2021 | ONSET DATE: 17 September 2021 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 2
  • IM
  • LA
  • EW0167

RECVDATE:17 September 2021
CAGE_YR:14
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:MOM SAYS NO
CUR_ILL:MOM SAYS NO
HISTORY:HEART SURGERY AT AGE 4
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:17 September 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:Y
ALLERGIES:MOM SAYS NO
V_FUNDBY:
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