VAERS ID: 1860476

AGE: 10| SEX: M|STATE: CA

Description

At 5:16pm the patient received 0.2mL of the Pediatric Pfizer vaccine. At 5:20pm the patient lost consciousness. The father grabbed the patient as he was falling to the ground and gently laid him on the ground. The father carried the patient to the cot. The patient reported feeling dizzy and nauseous. The patient denied any pain. The head of the bed was elevated. The patient denied any trouble breathing. At 5:24pm the patient's BP was 90/62 and HR was 110. At 5:24pm the patient vomited. At 5:24pm EMS was called. At 5:29pm the patient reported that he no longer felt dizzy. The patient was asked if he was itchy anywhere and he reported that his back was itchy. The back was assessed and hives were present across his back. The patient's parents reported that the patient has a history of breaking out in hives. The patient reported that his back was itchy before receiving the vaccine. At 5:31pm BP was 102/72 and RR 13. The fire department arrived at 5:35pm and assumed care of the patient. At 5:40pm BP was 118/77, HR 74, and O2 Sat 95%. At 5:41pm paramedics arrived on site and assumed care of the patient. At 5:43pm the patient was transported by the paramedics to the emergency room.

Symptoms

Dizziness, Dyspnoea, Loss of consciousness, Nausea, Pruritus, Urticaria, Vomiting

Vaccines

VAX DATE: 11-10-2021| ONSET DATE: 11-10-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH FK5127 IM AR

RECVDATE:11-11-2021
RPT_DATE:
CAGE_YR:10
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:U
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:
V_ADMINBY:PUB
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:11-11-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:no known allergies according to patient's mom
V_FUNDBY:

Questions? Comments? Bugs?
[email protected]
Due to the high volume of inquiries, please be patient with response times.

AND PLEASE read the FAQ first.

OpenVAERS is a private organization that posts publicly available CDC/FDA data of injuries reported post-vaccination. Reports are not proof of causality.