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VAERS ID: 1864539

AGE: 8| SEX: M|State: PR

Description

Patient reports feeling marked presents profuse sweating and pale color. Patient is evaluated by emergency medical personnel. 66r es Pulse 68 os/06 DXT 96 R 20. He is placed on a stretcher and observed for 30 minutes. Doctor is notified by family refers family history of vagal vessel. Vitals discharge SAT 100 Pulse 76 B/P 95/60 There are no restrictions when breathing.

Symptoms

Hyperhidrosis, Pallor

Vaccines

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

        RECVDATE:
        12 November 2021
        CAGE_YR:
        8
        CAGE_MO:
        RPT_DATE:
        DIED:
        DATEDIED:
        L_THREAT:
        ER_VISIT:
        HOSPITAL:
        HOSPDAYS:
        X_STAY:
        DISABLE:
        RECOVD:
        Y
        LAB_DATA:
        n/a
        V_ADMINBY:
        PUB
        OTHER_MEDS:
        n/a
        CUR_ILL:
        n/a
        HISTORY:
        n/a
        PRIOR_VAX:
        SPLTTYPE:
        FORM_VERS:
        2
        TODAYS_DATE:
        12 November 2021
        BIRTH_DEFECT:
        OFC_VISIT:
        ER_ED_VISIT:
        ALLERGIES:
        n/a
        V_FUNDBY:
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