This is VAERS ID 1855102

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History of Changes from the VAERS Wayback Machine

First Appeared on 11/12/2021

Vaccin­ation / Manu­facturer (2 vaccines)	Lot / Dose	Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH	FK5127 / 1	LA / IM
FLU4: INFLUENZA (SEASONAL) (AFLURIA QUADRIVALENT) / SEQIRUS, INC.	P100367901 / 1	RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Fall, Loss of consciousness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shortly after receiving his vaccines he was sitting on a chair and then started to pass out and fell to the floor. He was out for about 5 seconds. Pharmacist caught him and had him sit on the floor with his back to the wall, asked him questions such as name, where he was, who he was with. Provided water and a granola bar and had them stay in the pharmacy for an additional 30 minutes. Child was able to get up on his own and could walk by himself with no issues. Went home with family.

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