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This is VAERS ID 616561

Case Details

VAERS ID: 616561 (history)  
Form: Version 1.0  
Age: 65.0  
Gender: Female  
Location: Vermont  
   Days after vaccination:6
Submitted: 2015-12-22
   Days after onset:2
Entered: 2015-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium carbonate/vitamin D3; Cholecalciferol; Diphenhydramine; Doxylamine succinate; Lysine; Magnesium; Methylcellulose; Multivitamin; Naproxen
Current Illness: No illness noted
Preexisting Conditions: PMR (polymyalgia rheumatica); Heart murmur; Raynaud''s disease; Osteoporosis; Colon polyp
Diagnostic Lab Data: Patient seen by primary MD on 12/21/15
CDC Split Type:

Write-up: Patient developed redness, swelling and itching to right upper outer arm and painful to touch on 12/20/15. The redness, swelling and itching improved, however, was still present on 12/21/15. Patient seen in office visit on 12/21/15. Patient had been applying ice and cortisone cream at onset. This treatment and BENADRYL was recommended at MD visit.

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