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This is VAERS ID 1443162

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1443162
VAERS Form:2
Age:26.0
Sex:Female
Location:California
Vaccinated:2021-06-29
Onset:2021-06-29
Submitted:0000-00-00
Entered:2021-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0180 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Anaphylactic reaction, Swollen tongue, Pharyngeal 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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: none noted
Preexisting Conditions: none noted
Allergies: Allergic to pork
Diagnostic Lab Data: It is unknown was tests that were performed once patient was transported
CDC 'Split Type':

Write-up: Approximately 15 minutes post vaccination, patient started to show signs of anaphylactic reaction. Patient stated to the interpreter that her tongue was swelling and her throat was starting to close up. I administered 1 injection of Epi Pen to her left thigh. We summoned the resident RN on site. A pulse oximeter was placed on her left hand. She was administered oxygen via nasal cannula. I called 911 from my cell phone. Paramedics arrived on site in about 5 minutes. The paramedics made the decision to transport her to the local hospital

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