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VAERS ID: | 902770 |
VAERS Form: | 2 |
Age: | 50.0 |
Sex: | Female |
Location: | Arkansas |
Vaccinated: | 2020-12-15 |
Onset: | 2020-12-15 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-16 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EH9899 / 1 | AR / IM |
Administered by: Private Purchased by: ??
Symptoms: Pruritus, Rash maculo-papular
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:
Current Illness:
Preexisting Conditions:
Allergies: Lisinopril, Loracarbef, warfarin, Bydureon pen
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Patient started to develop maculopapular rash and itching starting ~15 minutes after the vaccine administration. The patient did not report shortness of breath or other respiratory symptoms. The patient was given IV diphenhydramine 50 mg, famotidine 20 mg IV, and methylprednisolone 125 mg IV. The patient''s symptoms resolved and was sent home with a Medrol dose pack and antihistamine.
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