VAERS ID: 1486595

AGE: 13| SEX: M|STATE: CA

Description

Systemic: Flushed / Sweating-Severe, Systemic: Headache-Medium, Additional Details: at 4:08pm 5 mins after giving shot, pt and mom complained of sweating and headache, put fan on pt while sitting and was fine after few minutes pt left with mom 4:18pm no issues

Symptoms

Flushing, Headache, Hyperhidrosis

Vaccines

VAX DATE: 07-19-2021| ONSET DATE: 07-19-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH ew0198 IM LA

RECVDATE:07-20-2021
RPT_DATE:
CAGE_YR:13
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:U
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:2
TODAYS_DATE:07-20-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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