National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1777965

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1777965
VAERS Form:2
Age:54.0
Sex:Female
Location:New Mexico
Vaccinated:2021-10-09
Onset:2021-10-09
Submitted:0000-00-00
Entered:2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 LA / SYR

Administered by: Other      Purchased by: ??
Symptoms: Hypersensitivity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: Mouth was numb durin the 30 minute waiting period.
Other Medications: Venlafaxine Floudrocortisol Metoprolol Succ ER Digoxin JARDIANCE JANUVIA Ozempic Albuterol inhaler Zyrtec D
Current Illness: Just allergies.
Preexisting Conditions: Diabetes Type 2 Asthma and Allergic Rhinitis Poly Orthostatic Tension Syndrome Tachycardia Low Blood Pressure Depression
Allergies: Quinolones like Levoquin and Avelox. Cephalosporins Keflex Sulfas Augmentin Cipro Bananas, pineapple, macadamias, hazelnuts, pistachios, Most trees and grass. Mold and dust. Horses, cows, dogs, and cats.
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Dose one, mouth felt numb. Dose three (booster) slow and gradual allergic reactions on left side of upper body and head.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1777965&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166