This is VAERS ID 1970404

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2021

Vaccin­ation / Manu­facturer (2 vaccines)	Lot / Dose	Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH	FL8095 / 1	LA / IM
FLUC4: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT) / SEQIRUS, INC.	308477 / N/A	RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dyspnoea, Nausea, Pallor, Seizure, 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: None known
Current Illness: None known
Preexisting Conditions: Acne rosacea
Allergies: Corn oil
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: A technician administered the flu and covid vaccines, then walked back to the pharmacy. About a minute later someone in the lobby reported an emergency, I (pharmacist) went to the lobby area to see the matter. Patient was on the floor and appeared to be waking up, his mother stated she thought he had convulsed then fainted. Patient stated he had difficulty breathing and was very pale, I administered 10mL of benadryl 12.5mg/5mL solution. Patient reported nausea and prepared to vomit, but he did not vomit. I stayed with patient to monitor him for changes while his mother called 911, patient stated he did not feel better or worse. EMS arrived shortly after and took over care. Patient''s family refused transport to hospital via EMS but did say they would drive to the hospital afterward. Of note, patient''s mother stated he had not had a reaction to a vaccine like this in the past, including the flu vaccine.

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