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This is VAERS ID 2440039

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Color Schemes (Before/After):

First Appeared on 9/16/2022

VAERS ID: 2440039
VAERS Form: 2
Age: 17.0
Sex: Male
Location: California
Vaccinated: 2022-09-10
Onset: 2022-09-10
Submitted: 0000-00-00
Entered: 2022-09-10
Vaccin­ation / Manu­facturer (2 vaccines) Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FP7141 / 1 LA / IM
FLUC4: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT) / SEQIRUS, INC. 942378 / N/A RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Headache, Seizure

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: No know allergies
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient appeared to be having a seizure for a short time (estimated to be less than a minute) after receiving his vaccines. The adverse event happened about a minute after receiving the vaccines. Upon awakening the patient felt normal other than having a small headache and possibly some difficulty breathing. Paramedics arrived and the patient''s mother elected to have him taken to the ER for more evaluation.

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