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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 2497198 |
VAERS Form: | 2 |
Age: | 15.0 |
Sex: | Female |
Location: | Utah |
Vaccinated: | 2022-11-02 |
Onset: | 2022-11-02 |
Submitted: | 0000-00-00 |
Entered: | 2022-11-02 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19-2: COVID19 (COVID19 (PFIZER-BIONTECH BIVALENT)) / PFIZER/BIONTECH | GJ2524 / UNK | LA / IM |
Administered by: Public Purchased by: ??
Symptoms: Abdominal pain, Loss of consciousness, Unresponsive to stimuli
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
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: Transferred by ems to HCF.
CDC 'Split Type':
Write-up: Received bivalent vaccine at community center and minutes(3)later she became unresponsive and passed out, less that 5 seconds. Placed on left side and awoke appropriate and complained of abdominal pain and I haven''t ate today. Transferred by EMS to local hospital awake, alert and ambulated to ambulance
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