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From the 1/7/2022 release of VAERS data:

Found 5,173 cases where Age is 5-or-more-and-under-12 and Location is U.S., Territories, or Unknown and Vaccine is COVID19 and Vaccination Date from '2021-11-01' to '2021-12-31'

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Case Details

This is page 7 out of 518

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VAERS ID: 1849016 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-06
Onset:2021-11-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Fall, Head injury
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient received Pediatric Pfizer Vaccine and stood up, leaned against pole and fell to the ground hitting head on the pole. No lost of consciousness noted. Small, round, red lump noted on left side of forehead. Pt c/o feeling dizzy. Pt placed in supine position with legs elevated. Ice to forehead. After a few minutes, patient stated he felt better and wanted to sit up. Pt placed in a wheelchair given juice and crackers. Pt stated dizziness gone and no headache or blurred vision. Lump size slightly decreased in size. Patient remained in Observation for up to 30 minutes was able to ambulate on own to exit.


VAERS ID: 1849019 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-11-06
Onset:2021-11-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Syringe issue
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Vaccine injected into L deltoid but none administered because frozen. On inspection the syringe looked like it contained over 0.2 mL but not opaque so a drop was squirted out to make 0.2 mL but when place in deltoid plunger wouldn''t go down probably because frozen (likely expanded and why over 0.2 mL). Syringe was on an ice pack.


VAERS ID: 1849023 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Na
Diagnostic Lab Data: Non
CDC Split Type:

Write-up: At around 1 pm he complained of stomach pain and nausea. He was in so much pain, he couldn?t talk.


VAERS ID: 1849034 (history)  
Form: Version 2.0  
Age: 8.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-01
Onset:2021-11-06
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Small white bumps on torso, not itchy


VAERS ID: 1849042 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-06
Onset:2021-11-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Injection site urticaria, Rash macular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: no known
Preexisting Conditions: Failed allergy injections due to adverse reactions
Allergies: Yes, but unknown
Diagnostic Lab Data: 12:15 BP 118/79 and Pulse 90 (normal range)
CDC Split Type:

Write-up: Patient received vaccination about 12:05 and had symptoms of localized hives near injection site. Arms appeared somewhat blotchy on both sides, but some of this blotchiness was reported to be normal skin conditiono. Patient reported no other symptoms of allergy, denyng warmth or itchiness.. Patient was given cold compress on the localized hives which reduced severity of the lesions. After about 30 minutes patient was released with parents, who wanted to give benadryl at home. No benadryl was administered at the vaccine clinic site.


VAERS ID: 1849044 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Female  
Location: California  
Vaccinated:2021-11-06
Onset:2021-11-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Posture abnormal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient was given first shot for covid vaccine. She was sitting in the chair for her 15 min wait time. Her mom was observing her child that fainted and slumped down in the chair. Mom caught the daughter and gently put her on the floor. She yelled out help the intern and the pharmacist went out to help with the situation. We moved the child to her side in case she''s had seizure or choked in something. Child did lose consciousness for 15 seconds, but then she regained consciousness and was breathing properly. The intern called emergency services and took patient to the local HCF.


VAERS ID: 1849045 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-11-06
Onset:2021-11-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Hunger, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: none
Preexisting Conditions: none
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Four siblings came with their mom to get the Pfizer 5-11 first dose. All four children sat on their moms lap while getting vaccinated. Daughter was the first child to get her shot and walked out of the booth to her siblings. It seemed like she was being silly and falling on her brother, but appears she may have fainted and quickly came to but not quite sure as The patient ran into the booth to her mother right after. She was a bit clammy and pale, so applied an ice pack to her face/forehead and nape of neck during observation time. The mom stated she was hungry and this had actually happened once before although during the screening she did not mention. I called the mom a few hours later and she said daughter had eaten lunch and was having ice cream and was doing just fine.


VAERS ID: 1849075 (history)  
Form: Version 2.0  
Age: 8.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-11-06
Onset:2021-11-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3521 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Immediate post-injection reaction, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: influenza vaccine within 30 seconds
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 30 seconds after the immunization was given the patient fainted. She was unconscious for less than 10 second. She did not hit her head or have any other trauma.


VAERS ID: 1849079 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-11-05
Onset:2021-11-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Incorrect dose administered by device, Needle issue
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Noted to have significant vaccine leakage on skin when I looked back at the video that I took. The nurse wiped off the fluid from skin. We were not notified at the time and now cannot determine how much vaccine patient received. Best guess is 75% (maybe)


VAERS ID: 1849091 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-06
Onset:2021-11-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: vasovagal reaction to vaccination
Other Medications: N/A
Current Illness: History of vasovagal reaction to vaccine
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: 12 05 PM: PATIENT LAY DOWN ON THE FLOOR, SAY HE FEEL DIZZI. SATURATION AT 100%, bp AT 101/61,hr 61/MIN. PATIENT LAY DOWN FLAT. EMS, SITE MANAGER, AND NP PRESENT. 12 11 PM: 106/59 ,SATURATION AT 100%, HR;81/MIN. PATIENT FEEL BETTER, PARENTS STATE THAT PATIENT HAD NO BREAKFAST THIS MORNING AND WENT TO SPORT PRACTICE BEFORE VACCINE. 12 14 PM: SEAT UPWRITH, PATIENT FEEL BETTER, DISCHARGE BY NURSE PRACTITIONAR.


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