| VAERS ID: |
902778 (history) |
| Form: |
Version 2.0 |
| Age: |
56.0 |
| Sex: |
Female |
| Location: |
Texas |
| Vaccinated: | 2020-12-15 |
| Onset: | 2020-12-15 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-16 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EH789592671001 / 1 |
LA / IM |
Administered by: Work Purchased by: ?
Symptoms: Blood pressure increased,
Headache,
Immediate post-injection reaction,
Injection site hypoaesthesia,
Injection site swelling
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metformin, glipizide, atorvastatin, ozempic, singulair, xopanex inhaler, xopenax nebulizer, epipen, flonase, pepcid AC, levothyroxine
Current Illness: radiation
Preexisting Conditions: Asthma, Diabetes, Capillary thyroid cancer (remission)
Allergies: shrimp, shellfish
Diagnostic Lab Data: No
CDC Split Type: vsafe
Write-up: Swelling and numbness at injection side. Increased blood pressure 199/99. Immediate headache. Workplace clinic called hospital ER, clinic administered Benadryl. Symptoms resolved. |
