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VAERS ID: 1862179

AGE: 8| SEX: F|State: IL

Description

Pfizer-BioNTech COVID-19 Vaccine EUA Patient had 10 min witnessed seizure 5hrs after receiving vaccine with no personal or family history of seizures. Patient was given VERSED 3mg by EMS, transported to Emergency Dept and recovered, discharged from ED after several hours of observation without any known residual morbidity.

Symptoms

Alanine aminotransferase normal, Blood chloride normal, Blood sodium normal, Haematocrit normal, White blood cell count increased, Aspartate aminotransferase normal, Blood creatinine decreased, Blood urea normal, Haemoglobin normal, Blood alkaline phosphatase increased, Blood glucose normal, Carbon dioxide normal, Laboratory test, Blood bilirubin normal, Blood magnesium increased, Electrocardiogram QT interval, Platelet count increased, Blood calcium normal, Blood potassium decreased, Electrocardiogram normal, Seizure

Vaccines

VAX DATE: 09 November 2021 | ONSET DATE: 09 November 2021 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • UNK
  • IM
  • LA
  • FK5127

RECVDATE:
10 November 2021
CAGE_YR:
8
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:
Y
LAB_DATA:
Labs done in ED visit 11/10/21-11/11/21 WBC 13.0 Hgb 12.6/Hct 37.2 Plt 490 Na 139 K 3.4 Cl 103 CO2 23 BUN 19 CRE 0.48 GLU 94 Mag 2.2 Ca 9.9 ALP 160 AST 32 ALT 25 T. Bil 0.5 EKG: NSR rate 115, QTc 350 ms, no acute ST abnl
V_ADMINBY:
SCH
OTHER_MEDS:
Fish Oil, Vitamin C, vitamin D, probiotics
CUR_ILL:
none
HISTORY:
autism
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
2
TODAYS_DATE:
10 November 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
Y
ALLERGIES:
yams
V_FUNDBY:
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