VAERS ID: 1864539

AGE: 8| SEX: M|STATE: PR (United States)

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.

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Symptoms

Pallor, Hyperhidrosis

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 FK 5127

RECVDATE:11-12-2021
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:
V_ADMINBY:PUB
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
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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