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VAERS ID: 2146565

AGE: 11| SEX: F|State: CA

Description

Pt stated she felt like she had to throw up then began feeling faint. Pt then threw up x1. Staff elevated feet, put head up, applied cool/wet towel. Temp 96.8. Pt reports not eating before taking vaccine. Offered water and food. Refused food. Drank 8oz water. Stated she felt better after throwing up. No further complaints of nausea or faintness. Able to stand and walk in own and appropriately. Mother present. Pt left with mother after observation period over.

Symptoms

Dizziness, Nausea, Vomiting

Vaccines

VAX DATE: 25 February 2022 | ONSET DATE: 25 February 2022 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 2
  • IM
  • LA
  • FL8095

RECVDATE:25 February 2022
CAGE_YR:11
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:Y
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:Patient Denies any medication taken
CUR_ILL:None reported
HISTORY:None reported
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:25 February 2022
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:None
V_FUNDBY:
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