This is VAERS ID 1993435

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2022

Vaccin­ation / Manu­facturer (2 vaccines)	Lot / Dose	Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH	FK5127 / 1	LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR	7J2CA / N/A	RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Blood thyroid stimulating hormone normal, C-reactive protein normal, Condition aggravated, Crying, Emotional disorder, Fatigue, Full blood count normal, Headache, Serum ferritin decreased, Red blood cell sedimentation rate normal, Epstein-Barr virus test, Thyroxine free normal, Blood test, Metabolic function test, Streptococcus test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: None
Current Illness: October 2021 had COVID illness- had brief fever and ST- symptoms lasted for 3-5 days.
Preexisting Conditions: None, but has ongoing ankle pain since summer 2021
Allergies: None known
Diagnostic Lab Data: Bloodwork obtained 12/30/21- CBCd, CMP, sed rate, CRP, TSH, FT4- all within normal range. Ferritin slight low at 15. EBV panel, ASO titer, antiDnaseB titer all pending.
CDC 'Split Type':

Write-up: Received COVID vaccine #1 (Pfizer for 5-11 yr) on 11/22/21 and two days later on 11/24/21, parents state when asked to perform simple task, he became significantly emotional, laid on garage cement floor, curled up and continued to cry for 2-3 hours. He has not had episodes like this previously. The emotional episodes has continue to reoccur since 11/24/21. He has previously had intermittent headaches for about a year and headaches have gradually worsened since 11/2021. He has had fatigue for the past several months that has worsened since 11/2021.

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