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This is VAERS ID 1757478

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1757478
VAERS Form:2
Age:54.0
Sex:Male
Location:Idaho
Vaccinated:2021-08-06
Onset:2021-09-06
Submitted:0000-00-00
Entered:2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chest discomfort, Face oedema, Lip swelling, 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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Psoriasis
Allergies: Shellfish Lidocaine Pfizer Covid-19 Vaccine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 2nd episode of extreme facial adema. Swelling of lips, cheeks, the exterior of throat to up to 10X normal size. Feeling of tightness in the middle of lungs. Persisted for over 24 hours, with minor swelling up to a week later.

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