| Days after vaccination:||0
|Vaccination / Manufacturer
||Lot / Dose
||Site / Route|
|COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH
||EW0173 / 1
||RA / SYR
Administered by: Work Purchased by: ?
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Previous Vaccinations: flu shot
Other Medications: Dexilant
Current Illness: chronic cough
Preexisting Conditions: chronic cough, SVT, RBBB, diverticulitis, uterine fibroids, Anemia, vocal cord polyps, acid reflux.
Allergies: codeine, sulfa,penicillin, mercury,bactrim, mushrooms
Diagnostic Lab Data: 911 called, EMT arrived. given 25mg of benadryl by nurse at covid vaccine clinic.
CDC Split Type:
Write-up: got hives within one to two minutes after getting shot on bright arm then minutes later left arm