On 12/29/21 Mom brought her daughter, to our pharmacy for a Pfizer pediatric vaccination. The mother brought 3 children, with the other two being younger than Patient. This was the second shot for all 3 kids. The correct vaccine and correct dose was given to all 3 children.  After giving all 3 children their shots, A let her mom know that she was feeling nauseous. I moved the trash can to be next to her. Patient threw up into the trash can and then looked very sick. She was extremely pale, lethargic, nearly asleep after being very "with it" and vibrant minutes before. She laid her head on the table in the clinical room. Patient stated that the nausea started when she watched me put the needle into her sister's arm. She said she did not watch me inject her shot, but she did watch me do her sister's shot and that is when the nausea started. Once she was a little less pale and slightly more awake, the family moved out of the clinical room to wait the required 15 minutes before they would leave. The mom asked me if the symptoms could be from the vaccine. I answered yes, but it is very difficult to tell whether it is the shot or anxiety about the shot that is the culprit, especially given the fact that Patient said it started when she saw the needle go into her sister's arm.  The child had no trouble breathing at any time during the event. I asked early on and a couple more times during the adverse event.  I send a text saying "I gave a 9 year old a shot. She threw up, is very white. No trouble breathing. Do I do anything more than just offer basic support like paper towels and water?" their response was "Basic support and if the parents want, we can contact ems."  The family had moved from the clinical room to wait outside the pharmacy for the required 15 minutes and I checked in with them at least 3 more times during that time. I offered to call ems if the mother wanted me to. She asked what I thought and I replied "I will call them if you want, but I don't think it is necessary. What I see is that even though she is still very pale, her color is returning and she is getting brighter." The mom agreed and said she did not think it was necessary either, and since by this time the 15 minute time for all of the kids had passed, and Patient looked a lot better, she would take them home.  Both other children were fine. I did not notice any symptoms in them and the mom did not point any out. The mom did, however, say that Patient had had a similar reaction (possibly more severe) and that they had taken her to a neurologist after it happened. She said that the doctor told them that the extremely heightened fear and anxiety in anticipation of a shot in children can cause that type of reaction. Notably, the mother had not mentioned at all or written in the form that the child had any reaction to a vaccine previously.  The one thing the mom did mention about the kids is that they all had a very slight cough. I questioned about how bad, how often, if any of them had any trouble breathing or a fever and the mom said no to all of those things. Notably, I did not hear any of them cough while at the window or in the clinical room, or outside the pharmacy during the adverse event.  Today 12/30/21 I called mom to check on Patient. She said "You are so absolutely sweet!" and said that Patient is back to her normal self and has had no problems at all since bringing her home.  Pfizer 5-11 Lot: FL8094 Exp: 3/3/22