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This is VAERS ID 1367770

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1367770
VAERS Form:2
Age:34.0
Sex:Female
Location:Florida
Vaccinated:2021-06-02
Onset:2021-06-02
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Swollen tongue

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: OCP Ariprozole 20 mg qd, Pantropozole20 mg qd, Sertraline 200 mg qd, Prazosin 1 mg qpm Trazadone 50 mg qpm
Current Illness: none
Preexisting Conditions: Depression and anxiety
Allergies: Celery, Mustard
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Pt c/o tongue swelling without difficulty breathing, EMS called . Epinephrine 0.3mg administered. EMS arrived,swelling less . After discussion with EMS and mother pt agreed to transport to Hospital.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1367770&WAYBACKHISTORY=ON


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