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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 1912790 |
VAERS Form: | 2 |
Age: | 10.0 |
Sex: | Male |
Location: | North Dakota |
Vaccinated: | 2021-12-01 |
Onset: | 2021-12-01 |
Submitted: | 0000-00-00 |
Entered: | 2021-12-01 |
Vaccination / Manufacturer (2 vaccines) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | FL0007 / 1 | RA / IM |
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR | UT7378JA / 1 | LA / IM |
Administered by: Private Purchased by: ??
Symptoms: Dizziness, Syncope
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: Common cold in the last month.
Preexisting Conditions: n/a
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Dizzy and Faint, pt seated and given a cold pack with orange juice and crackers. Outcome: pt reports feeling "better than before" after 15 minutes.
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