VAERS ID: 1863833

AGE: 7| SEX: F|STATE: CA (United States)

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.

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Symptoms

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

Vaccines

VAX DATE: 11-11-2021| ONSET DATE: 11-11-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH IM RA

RECVDATE:11-12-2021
RPT_DATE:
CAGE_YR:7
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
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:
TODAYS_DATE:11-12-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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