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VAERS ID: 2109634

AGE: 14| SEX: F|State: CO

Description

Patient has needle phobia, she was so afraid of the vaccine that she had diarrhea before the shot. She felt faint and slouched on the chair and lost consciousness for a brief moment.

Symptoms

Diarrhoea, Dizziness, Fear of injection, Loss of consciousness

Vaccines

VAX DATE: 12 February 2022 | ONSET DATE: 12 February 2022 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 2
  • IM
  • LA
  • FK9729

RECVDATE:12 February 2022
CAGE_YR:14
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:
LAB_DATA:
V_ADMINBY:PHM
OTHER_MEDS:
CUR_ILL:
HISTORY:ASTHMA
PRIOR_VAX:Per mom, patient gets anxiety attacks when getting vaccines. Fainted when getting her ears pierced.
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:12 February 2022
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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