National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/19/2021 release of VAERS data:

This is VAERS ID 1350701

Government Disclaimer on use of this data

Case Details

VAERS ID: 1350701 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: North Carolina  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Lip swelling, Mouth swelling, Paraesthesia oral, Pharyngeal paraesthesia, Pharyngeal swelling, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: amoxicillin, atenolol, baclofen, cyclobenzaprine, hyoscyamine, lithium, meclizine, sulfa, tetracaine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the Emergency Room via EMS with lip, palette, and throat swelling and tingling, itching, and hives. The patient was treated with epinephrine x 2 doses and diphenhydramine. The patient began having symptoms soon after receiving the Johnson and Johnson COVID 19 vaccine.

New Search

Link To This Search Result:

Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166