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This is VAERS ID 2032631

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History of Changes from the VAERS Wayback Machine

Color Schemes (Before/After):

First Appeared on 1/14/2022

VAERS ID: 2032631
VAERS Form: 2
Age: 11.0
Sex: Female
Location: Florida
Vaccinated: 2022-01-08
Onset: 2022-01-08
Submitted: 0000-00-00
Entered: 2022-01-13
Vaccin­ation / Manu­facturer (2 vaccines) Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FL0007 / 1 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UT7378LA / N/A RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Dizziness, Hyperhidrosis, Pallor, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NKA
Diagnostic Lab Data: NA
CDC 'Split Type':

Write-up: Patient became lightheaded about 5 minutes after vaccine administration. She then started to sweat and turn white and finally fainted. After lying her on the floor she woke up almost immediately. No further complications after that

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