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This is VAERS ID 1715573

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First Appeared on 9/24/2021

VAERS ID: 1715573
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Pharmacy      Purchased by: ??
Symptoms: Oral mucosal blistering, Oral pain, Stomatitis, Throat irritation, Oropharyngeal blistering, Oropharyngeal pain, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 40 mg Multi Vitamin Vitamin D Baby aspirin
Current Illness: None
Preexisting Conditions: Kidney Disease Stage 3 High BP
Allergies: Erythromycin - upset stomach
Diagnostic Lab Data: COVID 19 Test - Negative result on 9/15/21
CDC 'Split Type':

Write-up: Approximately 1.5 hours after receiving shot I felt a sore throat coming on. It continued to feel that way for the next few days. Then on the afternoon of 9/14/21 my mouth and throat started to blister and became very painful. I immediately started to drink ice water to help with the pain. The pain persisted for hours until I fell asleep. I woke up the next morning and the sores seemed to have resolved for the most part, but was unsure of whether or not to receive a second dose. I made an appointment with a doctor to look at and she stated most of it had resolved but noticed some irritation.

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