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This is VAERS ID 907256

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 907256
VAERS Form:2
Age:35.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Anxiety, Dysphagia, Heart rate increased, Injection site pain, Pain, Pain in jaw, Pain of skin, Palpitations, Peripheral coldness, Swelling face, Oropharyngeal discomfort, 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:
Current Illness:
Preexisting Conditions:
Allergies: Septra
Diagnostic Lab Data:
CDC 'Split Type': IHS

Write-up: *Describe the adverse event(s), treatment, and outcome(s), if any: (symptoms, signs, time course, etc.) S: 35 yo F who received Pfizer vaccine at 16:47 w/acute onset of left sided facial swelling and difficulty swallowing. Within five minutes of being administered vaccination, pt reported pain at the injection site radiating up to her jaw followed by left sided facial swelling. She started reported palpitations and subsequently reported a ball in her throat O: Pulse was in the 60''s, BP of 128/72, pulse of 88-97 satting at 99% on RA. General: young female, anxious. HEENT: NC, AT, mild left sided cheek swelling, OP clear, MMM. Neck: Supple, left sided tender cervical LN. Lungs: CTAB. CV: tachycardic rate, regular rhythm. Extremities: Hands are clenched and cold. Neuro: Alert & oriented. A/P: Anaphylaxis -Given left facial swelling, 25 mg Benadryl PO administered. pt tolerated well. -17:22-Throat swelling reported. EPI #1 administered right thigh. -17:32-EPI #2 administered. Throat felt better at 17:35. 17:36-FD EMS arrived. BP 194/126. -17:38-EPI #3 administered right thigh. HR 135, BP 154/105. -17:43-EPI #4 administered left thigh. -17:46 pt transported to ER via EMS.


Changed on 1/29/2021

VAERS ID: 907256 Before After
VAERS Form:2
Age:35.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Anxiety, Dysphagia, Heart rate increased, Injection site pain, Pain, Pain in jaw, Pain of skin, Palpitations, Peripheral coldness, Swelling face, Oropharyngeal discomfort, 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:
Current Illness:
Preexisting Conditions:
Allergies: Septra
Diagnostic Lab Data:
CDC 'Split Type': IHS (blank)

Write-up: *Describe the adverse event(s), treatment, and outcome(s), if any: (symptoms, signs, time course, etc.) S: 35 yo F who received Pfizer vaccine at 16:47 w/acute onset of left sided facial swelling and difficulty swallowing. Within five minutes of being administered vaccination, pt reported pain at the injection site radiating up to her jaw followed by left sided facial swelling. She started reported palpitations and subsequently reported a ball in her throat O: Pulse was in the 60''s, BP of 128/72, pulse of 88-97 satting at 99% on RA. General: young female, anxious. HEENT: NC, AT, mild left sided cheek swelling, OP clear, MMM. Neck: Supple, left sided tender cervical LN. Lungs: CTAB. CV: tachycardic rate, regular rhythm. Extremities: Hands are clenched and cold. Neuro: Alert & oriented. A/P: Anaphylaxis -Given left facial swelling, 25 mg Benadryl PO administered. pt tolerated well. -17:22-Throat swelling reported. EPI #1 administered right thigh. -17:32-EPI #2 administered. Throat felt better at 17:35. 17:36-FD EMS arrived. BP 194/126. -17:38-EPI #3 administered right thigh. HR 135, BP 154/105. -17:43-EPI #4 administered left thigh. -17:46 pt transported to ER via EMS.


Changed on 5/7/2021

VAERS ID: 907256 Before After
VAERS Form:2
Age:35.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Anxiety, Dysphagia, Heart rate increased, Injection site pain, Pain, Pain in jaw, Pain of skin, Palpitations, Peripheral coldness, Swelling face, Oropharyngeal discomfort, 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:
Current Illness:
Preexisting Conditions:
Allergies: Septra Septra
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: *Describe the adverse event(s), treatment, and outcome(s), if any: (symptoms, signs, time course, etc.) S: 35 yo F who received Pfizer vaccine at 16:47 w/acute onset of left sided facial swelling and difficulty swallowing. Within five minutes of being administered vaccination, pt reported pain at the injection site radiating up to her jaw followed by left sided facial swelling. She started reported palpitations and subsequently reported a ball in her throat O: Pulse was in the 60''s, BP of 128/72, pulse of 88-97 satting at 99% on RA. General: young female, anxious. HEENT: NC, AT, mild left sided cheek swelling, OP clear, MMM. Neck: Supple, left sided tender cervical LN. Lungs: CTAB. CV: tachycardic rate, regular rhythm. Extremities: Hands are clenched and cold. Neuro: Alert & oriented. A/P: Anaphylaxis -Given left facial swelling, 25 mg Benadryl PO administered. pt tolerated well. -17:22-Throat swelling reported. EPI #1 administered right thigh. -17:32-EPI #2 administered. Throat felt better at 17:35. 17:36-FD EMS arrived. BP 194/126. -17:38-EPI #3 administered right thigh. HR 135, BP 154/105. -17:43-EPI #4 administered left thigh. -17:46 pt transported to ER via EMS.


Changed on 5/14/2021

VAERS ID: 907256 Before After
VAERS Form:2
Age:35.0
Sex:Female
Location:Alaska
Vaccinated:2020-12-22
Onset:2020-12-22
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaphylactic reaction, Anxiety, Dysphagia, Heart rate increased, Injection site pain, Pain, Pain in jaw, Pain of skin, Palpitations, Peripheral coldness, Swelling face, Oropharyngeal discomfort, 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:
Current Illness:
Preexisting Conditions:
Allergies: Septra Septra
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: *Describe the adverse event(s), treatment, and outcome(s), if any: (symptoms, signs, time course, etc.) S: 35 yo F who received Pfizer vaccine at 16:47 w/acute onset of left sided facial swelling and difficulty swallowing. Within five minutes of being administered vaccination, pt reported pain at the injection site radiating up to her jaw followed by left sided facial swelling. She started reported palpitations and subsequently reported a ball in her throat O: Pulse was in the 60''s, BP of 128/72, pulse of 88-97 satting at 99% on RA. General: young female, anxious. HEENT: NC, AT, mild left sided cheek swelling, OP clear, MMM. Neck: Supple, left sided tender cervical LN. Lungs: CTAB. CV: tachycardic rate, regular rhythm. Extremities: Hands are clenched and cold. Neuro: Alert & oriented. A/P: Anaphylaxis -Given left facial swelling, 25 mg Benadryl PO administered. pt tolerated well. -17:22-Throat swelling reported. EPI #1 administered right thigh. -17:32-EPI #2 administered. Throat felt better at 17:35. 17:36-FD EMS arrived. BP 194/126. -17:38-EPI #3 administered right thigh. HR 135, BP 154/105. -17:43-EPI #4 administered left thigh. -17:46 pt transported to ER via EMS.

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