National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 9/10/2021 release of VAERS data:

This is VAERS ID 1388404



Case Details

VAERS ID: 1388404 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-06-03
Onset:2021-06-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Lip swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Calcium, Vitamin D3, Omega 3
Current Illness: Sprained Wrist
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: There were no medical tests done at either Emergency Room.
CDC Split Type:

Write-up: Extreme Hive Break Out for three days. Extreme Lip Swelling. I have plenty of pictures if you want them. We went to Emergency room on Friday and they gave her an IV with Antihistamine and Steroids and Pepcid. She got better and we went home. She broke out again all over her body on Saturday and this time we went to Emergnecy room. They observed her and basically told us when they discharged us to keep her on Benadryl every four hours for the next 48 hours. I think it''s important to note that she did test positive for COVID 19 on December 11, 2020 and had a fairly mild case of the virus. ALso, that she has never had this reaction to anything ever before.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1388404


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