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VAERS ID: 1863833

AGE: 7| SEX: F|State: CA

Description

Patient immediately went pale, felt dizzy and vomited multiple times. After sitting for 10 minutes and having a drink she felt significantly better but was still off balance for over 30 minutes after.

Symptoms

Balance disorder, Dizziness, Immediate post-injection reaction, Pallor, Vomiting

Vaccines

VAX DATE: 10 November 2021 | ONSET DATE: 10 November 2021 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 1
  • IM
  • RA

RECVDATE:
11 November 2021
CAGE_YR:
7
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:
Y
LAB_DATA:
V_ADMINBY:
PVT
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
Vomiting within 5 minutes of vaccination. Occurred with influenza vaccine on 11/6/2020 when patient was 6 years & 6 months old.
SPLTTYPE:
FORM_VERS:
2
TODAYS_DATE:
11 November 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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