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 1779068

Government Disclaimer on use of this data

Case Details

VAERS ID: 1779068 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Michigan  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Injection site pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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:
Other Medications: Morphine sulfate ER,Famotidine, Verapamil ER, Lamictal XR, Trokendi XR, Levetiracetam ER, Vitamin D, Calcium/vitamin D
Current Illness: None
Preexisting Conditions: Ehlers-danlos syndrome, Sjogren''s syndrome, Hashimoto''s, Chronic pain
Allergies: Keflax, tofranil
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Slight swelling, deep down itching at injection site. Still there on Oct 11

New Search

Link To This Search Result:

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