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This is VAERS ID 1415821

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1415821
VAERS Form:2
Age:36.0
Sex:Male
Location:Foreign
Vaccinated:2021-06-03
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Hypersensitivity, Lip swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FEXOFENADINE; LEVOTHYROXINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy; Hypothyroidism; Immunodeficiency (Has an illness or condition, not listed above, which reduces the immune response (e.g. immunodef...)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GBPFIZER INC2021657771

Write-up: lower lip started swelling; Allergy; This is a spontaneous report from a contactable consumer received from the Regulatory Authority (RA). The regulatory authority report number is GB-MHRA-WEBCOVID-202106042253016300-URDGP. Safety Report Unique Identifier GB-MHRA-ADR 25424744. A 36-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration on 03Jun2021 (at age of 36 years old) (Batch/Lot number was not reported) as single dose for COVID-19 immunization. Medical history included immunodeficiency (Has an illness or condition, not listed above, which reduces the immune response (e.g. immunodef), Allergy and Hypothyroidism. Concomitant medication(s) included fexofenadine taken for hypersensitivity from 16Feb2021 to an unspecified stop date; levothyroxine taken for hypothyroidism from 01Aug2016 to an unspecified stop date. The patient experienced allergy on 03Jun2021 with outcome of recovered on 03Jun2021, lower lip started swelling on an unspecified date with outcome of recovered. Clinical course as reported: My lower lip started swelling. I took Fexofenadine Anti-histamine tablets n recovered in 20mins, Patient has not tested positive for COVID-19 since having the vaccine. Patient has not had symptoms associated with COVID-19, Not had a COVID-19 test Patient is not enrolled in clinical trial. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.

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