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VAERS ID: 2315265

AGE: 9| SEX: F|State: CA

Description

Systemic: Flushed / Sweating-Mild, Systemic: Nausea-Mild, Additional Details: about 1 minutes after covid 19 Pfiezer 5-11 yrs vaccine, patient complains of nausea. look pale on face. no fever. sweat a little bit. patient is responsive. Blood pressure was 58/43, heartbeat 55. mother was give her a sip of drink which she brought with her. After 15 minutes blood pressure was taken again at 91/77. heartbeat 84. patient looks almost back to normal.

Symptoms

Blood pressure decreased, Heart rate irregular, Hyperhidrosis, Nausea, Pallor

Vaccines

VAX DATE: 05 June 2022 | ONSET DATE: 05 June 2022 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 2
  • IM
  • LA
  • fl8094

RECVDATE:09 June 2022
CAGE_YR:9
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:Y
LAB_DATA:
V_ADMINBY:PHM
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:09 June 2022
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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