National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/19/2021 release of VAERS data:

This is VAERS ID 1778783

Government Disclaimer on use of this data

Case Details

VAERS ID: 1778783 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Nebraska  
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Fluid retention, Lymph node pain, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetanus Shot: Localized swelling in the arm Penicillin Shot: Hospitalized
Other Medications: Losartan 100mg (once daily)
Current Illness: None
Preexisting Conditions: High Blood Pressure
Allergies: Penicillin Codeine Sulfa
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Small rough bumps on right arm, raised whelps that itched and spread through the body, joint aches in legs and arms, sensitivity in lymph nodes in neck, fluid retention underneath both eyes

New Search

Link To This Search Result:

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