VAERS ID: 1771818

AGE: 16| SEX: F|STATE: CA (United States)

Description

Dad reports patient fine throughout the night with no fever. Got up in morning of 10/8/21 with temp of 96.7. Dad was fixing breakfast about 1/2 later & noticed she looked glossy eyed. Took temp again & she was 99. A few min. later she began seizing . Dad called for ambulance Patient had a seizure for 30 min. resolved after 10mg dose of intranasal versed with some left sided twitching. Also given Ativan & 60mg/kilogram of Keppra. Had, lab work, CXR, EKG & CT of head. Patient transferred to Hospital for further evaluation after overnight stay.

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Symptoms

Muscle twitching, Condition aggravated, Laboratory test, Chest X-ray, Electrocardiogram, C-reactive protein normal, Computerised tomogram head, Blood creatine phosphokinase normal, Full blood count abnormal, Metabolic function test abnormal, Differential white blood cell count abnormal, Blood lactic acid abnormal, Glassy eyes, Seizure

Vaccines

VAX DATE: 10-07-2021| ONSET DATE: 10-08-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH 30155BA IM LA

RECVDATE:10-08-2021
RPT_DATE:
CAGE_YR:16
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:CBC qith Auto Diff-Abnormal Comprehensive Metabolic-Abnormal Lactate-Abnormal CPK-Normal C-Reactive Protein-Normal
V_ADMINBY:PVT
OTHER_MEDS:
CUR_ILL:
HISTORY:Seizure disorder-under control without meds for several years Congenital heart disease S/P PDA repair Bilat hearing loss developmental delay Colon polyps
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:10-08-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:Prochlorperazine, compazine
V_FUNDBY:

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