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VAERS ID: | 909778 |
VAERS Form: | 2 |
Age: | 20.0 |
Sex: | Female |
Location: | Virginia |
Vaccinated: | 2020-12-26 |
Onset: | 2020-12-26 |
Submitted: | 0000-00-00 |
Entered: | 2020-12-27 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | - / 1 | LA / IM |
Administered by: Work Purchased by: ??
Symptoms: Dysphagia, Electroencephalogram, Pruritus, Swollen tongue, Urticaria, Psychogenic seizure, Tongue pruritus
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? Yes, days: 2
Extended hospital stay? No
Previous Vaccinations:
Other Medications: Depovera
Current Illness:
Preexisting Conditions: Asthma
Allergies: Morphine, penicillin, Shellfish, iodine, honey, pollen, dust
Diagnostic Lab Data: EEG
CDC 'Split Type':
Write-up: 8:27 Hives, itching all over chest and on tongue, tongue swelling, slight difficulty swallowing. 8:30 epi administered/ benedrly 8:32 pseudo seizures begin off and on till the 27th
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