VAERS ID: 1825452

AGE: 13| SEX: F|STATE: CA (United States)

Description

Approximately 15 minutes after vaccine, patient states she felt 'unbalanced.' Upon assessment patient is a&o x4, answering questions appropriately and does not appear to be altered. Describes sensation of feeling the room spinning when she stands up. patient has HX of Anxiety and states that she feels similar to her Anxiety and that she feels anxious at this time. Patient was taken to school nurse and parent called to pick up student. Vitals taken; BP 127/74, HR 90

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Symptoms

Vertigo, Anxiety, Balance disorder

Vaccines

VAX DATE: 10-26-2021| ONSET DATE: 10-26-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH FF8841 IM RA

RECVDATE:10-28-2021
RPT_DATE:
CAGE_YR:13
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:
V_ADMINBY:SCH
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:10-28-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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