VAERS ID: 2265776

AGE: 23| SEX: F|STATE: NJ (United States)

Description

Systemic: Fainting / Unresponsive-Mild, Additional Details: shortly after pt received her pfizer booster she fainted, she regained consciousness within 20-30 seconds and the police and EMS were called onsite, they evaluated pt and escorted her out, after patient regained consciousness she did mention that she had fainted in the past after receiving a vaccination in her teens

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Symptoms

Syncope, Unresponsive to stimuli

Vaccines

VAX DATE: 05-02-2022| ONSET DATE: 05-02-2022| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 3 COVID19 PFIZER\BIONTECH fp4554 IM LA

RECVDATE:05-06-2022
RPT_DATE:
CAGE_YR:23
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:
V_ADMINBY:PHM
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:05-06-2022
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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