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This is VAERS ID 907526

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 907526
VAERS Form:2
Age:60.0
Sex:Female
Location:California
Vaccinated:2020-12-21
Onset:2020-12-21
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site rash, Petechiae, Swelling, Swelling face, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations: to TDAP, Tetanus Toxoid and Influenza
Other Medications: takes bendaryl, Loratadine, & rescue inhaler PRN
Current Illness: No
Preexisting Conditions: hx sinusitis, asthma
Allergies: hx of allergy to influenza vaccine, TDAP & Tetanus Toxoid
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Per Vaccine recipient approximately 4-4 1/2 hours after receiving vaccine she noticed facial swelling in and around nose, to neck area, to R elbow and a petechial rash near R elbow. She immediately took Benadryl and Pepcid and then went to ER for further evaluation, where she was given a dose of Zyrtec and 5 day course of Prednisone. She left ER with no further complication.


Changed on 5/7/2021

VAERS ID: 907526 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:California
Vaccinated:2020-12-21
Onset:2020-12-21
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site rash, Petechiae, Swelling, Swelling face, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations: to TDAP, Tetanus Toxoid and Influenza
Other Medications: takes bendaryl, Loratadine, & rescue inhaler PRN
Current Illness: No
Preexisting Conditions: hx sinusitis, asthma
Allergies: hx of allergy to influenza vaccine, TDAP & Tetanus Toxoid Toxoid
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Per Vaccine recipient approximately 4-4 1/2 hours after receiving vaccine she noticed facial swelling in and around nose, to neck area, to R elbow and a petechial rash near R elbow. She immediately took Benadryl and Pepcid and then went to ER for further evaluation, where she was given a dose of Zyrtec and 5 day course of Prednisone. She left ER with no further complication.


Changed on 5/14/2021

VAERS ID: 907526 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:California
Vaccinated:2020-12-21
Onset:2020-12-21
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site rash, Petechiae, Swelling, Swelling face, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations: to TDAP, Tetanus Toxoid and Influenza
Other Medications: takes bendaryl, Loratadine, & rescue inhaler PRN
Current Illness: No
Preexisting Conditions: hx sinusitis, asthma
Allergies: hx of allergy to influenza vaccine, TDAP & Tetanus Toxoid Toxoid
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Per Vaccine recipient approximately 4-4 1/2 hours after receiving vaccine she noticed facial swelling in and around nose, to neck area, to R elbow and a petechial rash near R elbow. She immediately took Benadryl and Pepcid and then went to ER for further evaluation, where she was given a dose of Zyrtec and 5 day course of Prednisone. She left ER with no further complication.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=907526&WAYBACKHISTORY=ON


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