VAERS ID: 1862179

AGE: 8| SEX: F|STATE: IL (United States)

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.

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Symptoms

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

Vaccines

VAX DATE: 11-10-2021| ONSET DATE: 11-10-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 0 COVID19 PFIZER\BIONTECH FK5127 IM LA

RECVDATE:11-11-2021
RPT_DATE:
CAGE_YR:8
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
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:
TODAYS_DATE:11-11-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:yams
V_FUNDBY:

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