VAERS ID: |
902895 (history) |
Form: |
Version 2.0 |
Age: |
50.0 |
Sex: |
Female |
Location: |
North Carolina |
Vaccinated: | 2020-12-16 |
Onset: | 2020-12-16 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
2020-12-17 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EK5730 / 1 |
RA / IM |
Administered by: Military Purchased by: ? Symptoms: Cough,
Dry throat,
Rash SMQs:, Anaphylactic reaction (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu vaccine 2017 Other Medications: Flintstone vitamin 1 tab daily Align Probiotic 1 capsule daily Black Elderberry Gummie 1 gummie daily Caltrate Soft Chews for Bone health 1 chew daily Cetirizine 10 mg 1 tab PRN as needed for seasonal allergies Current Illness: None Preexisting Conditions: None Allergies: Penicillin Vicodin Fentanyl Citalopram One reaction to 2017 flu vaccine Diagnostic Lab Data: None at this time CDC Split Type:
Write-up: Systemic rash, dry cough (causing cough); 650mg Tylenol every 6; 50mg Benadryl to start then 25 mg every 6, Pepcid 20mg every 12 hours; rash is slowly resolving; throat still very dry with dry cough |