| VAERS ID: |
902446 (history) |
| Form: |
Version 2.0 |
| Age: |
55.0 |
| Sex: |
Female |
| Location: |
West Virginia |
| Vaccinated: | 2020-12-15 |
| Onset: | 2020-12-15 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-15 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH9899 / 1 |
RA / IM |
Administered by: Other Purchased by: ?
Symptoms: Erythema,
Feeling hot,
Flushing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), 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: Novasc, Hydrochlorothiazide, synthroid, lisinopril, singulair, MVI, olopatadine drops, prilosec, inderal, crestor, toviaz, ultram
Current Illness: none
Preexisting Conditions: Hypertension, sleep apnea, hypothyroidism
Allergies: Contrast Dye IV contrast, shellfish, strawberry
Diagnostic Lab Data: She took Benadryl 50 mg po. No medical tests done. After benadryl, was administered by herself, flushing went away and she felt better.
CDC Split Type:
Write-up: felt warm, hot and face and ears were red and flushed. |
