This is VAERS ID 1870113

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History of Changes from the VAERS Wayback Machine

First Appeared on 11/19/2021

Vaccin­ation / Manu­facturer (2 vaccines)	Lot / Dose	Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH	FK5618 / 1	LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR	UT7347MA / N/A	RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dizziness, Fall, Syncope

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall CR Melatonin Diphenhydramine
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: NKA
Diagnostic Lab Data: NA
CDC 'Split Type':

Write-up: Patient presented to clinic as walk in for a COVID-19 vaccine and flu vaccine. Patient received both vaccines as indicated above. Patient stood up and proceeded to the door in which she became faint with syncope response. Evaluated by Dr. with monitoring 30+ minutes following episode. Patient left with family to home. Patient did later present to hometown ED for evaluation due to concern of concussion from fall.

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