National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 6/11/2021 release of VAERS data:

This is VAERS ID 903766



Case Details

VAERS ID: 903766 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Arizona  
Vaccinated:2020-12-17
Onset:2020-12-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angioedema, Full blood count, Human chorionic gonadotropin, Metabolic function test
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxine 100 mcg, albuterol HFA, Wellbutrin XL
Current Illness: None
Preexisting Conditions: CSF leak, migraines, asthma
Allergies: Amoxicillin (hives), divalproex (swelling)
Diagnostic Lab Data: CBC, BMP, HCG
CDC Split Type:

Write-up: Angioedema


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=903766


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