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This is VAERS ID 904418

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 904418
VAERS Form:2
Age:38.0
Sex:Female
Location:California
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Angioedema, Pruritus, Throat tightness, Laboratory test normal, Hypoaesthesia oral, Pharyngeal swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Went to the Emergency Department for care on 12/19. Normal lab work. Received IV medications.
CDC 'Split Type':

Write-up: Initially started as numbness of the lips, then progressed to angioedema (swelling of the lips) with face itchiness. Then progressed to throat tightening and swelling feeling, consistent with anaphylaxis.


Changed on 5/7/2021

VAERS ID: 904418 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:California
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Angioedema, Pruritus, Throat tightness, Laboratory test normal, Hypoaesthesia oral, Pharyngeal swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: Went to the Emergency Department for care on 12/19. Normal lab work. Received IV medications.
CDC 'Split Type':

Write-up: Initially started as numbness of the lips, then progressed to angioedema (swelling of the lips) with face itchiness. Then progressed to throat tightening and swelling feeling, consistent with anaphylaxis.


Changed on 5/14/2021

VAERS ID: 904418 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:California
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Angioedema, Pruritus, Throat tightness, Laboratory test normal, Hypoaesthesia oral, Pharyngeal swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: Went to the Emergency Department for care on 12/19. Normal lab work. Received IV medications.
CDC 'Split Type':

Write-up: Initially started as numbness of the lips, then progressed to angioedema (swelling of the lips) with face itchiness. Then progressed to throat tightening and swelling feeling, consistent with anaphylaxis.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=904418&WAYBACKHISTORY=ON

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