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This is VAERS ID 907616

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 907616
VAERS Form:2
Age:53.0
Sex:Female
Location:New Mexico
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 - / IM

Administered by: Other      Purchased by: ??
Symptoms: Anaphylactic reaction, Dyspnoea, Hypersensitivity, Pruritus, Urticaria

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)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: ? Past Medical History: Diagnosis Date ? Addison''s disease (CMS-HCC) 03/2015 ? Asthma (CMS-HCC) ? ? Disorder of thyroid (CMS-HCC)
Allergies: meperidine, morphine=anaphylaxis flagyl=pancreatitis
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12-22 HPI 53-year-old female with a history of Addison''s disease, anaphylactic reaction who presents to the ED complaining of hives and shortness of breath. Patient reports that 3 days ago she received the COVID-19 pfizer vaccine. She reports that since that time she has developed progressively worsening hives on her legs and arms. Approximately 1 hour ago she began to develop shortness of breath and so she presented to the ER. Patient reports a previous history of anaphylactic reactions multiple times. Denies any other acute complaints at this time. MDM Patient came in with shortness of breath and hives. Suspect allergic reaction to the COVID-19 vaccine. Patient had already taken 50 mg of Benadryl. She was given Solu-Medrol and EpiPen. She reported feeling better with improvement in the pruritus. She reports that she has had rebound reaction requiring EpiPen at 24 hours. Given the distance that she lives from adequate medical care and the possibility for recurrent severe reactions, the patient will be hospitalized for further observation. 12-23 Female with history of asthma and addison''s had anaphylaxis to covid vaccine. Admitted over night to ensure that she did not rebound. Received IV Dex and this am has had no reoccurrence of hives or shortness of breath. Will discharge home on epipen, hydrocortisone prn, prednisone bid for 5 days. Return to ER or go to PCP for worsening symptoms.


Changed on 4/23/2021

VAERS ID: 907616 Before After
VAERS Form:2
Age:53.0
Sex:Female
Location:New Mexico
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 - / IM

Administered by: Other      Purchased by: ??
Symptoms: Anaphylactic reaction, Dyspnoea, Hypersensitivity, Pruritus, Urticaria

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)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: ? Past Medical History: Diagnosis Date ? Addison''s disease (CMS-HCC) 03/2015 ? Asthma (CMS-HCC) ? ? Disorder of thyroid (CMS-HCC)
Allergies: meperidine, morphine=anaphylaxis flagyl=pancreatitis
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12-22 HPI 53-year-old female with a history of Addison''s disease, anaphylactic reaction who presents to the ED complaining of hives and shortness of breath. Patient reports that 3 days ago she received the COVID-19 pfizer vaccine. She reports that since that time she has developed progressively worsening hives on her legs and arms. Approximately 1 hour ago she began to develop shortness of breath and so she presented to the ER. Patient reports a previous history of anaphylactic reactions multiple times. Denies any other acute complaints at this time. MDM Patient came in with shortness of breath and hives. Suspect allergic reaction to the COVID-19 vaccine. Patient had already taken 50 mg of Benadryl. She was given Solu-Medrol and EpiPen. She reported feeling better with improvement in the pruritus. She reports that she has had rebound reaction requiring EpiPen at 24 hours. Given the distance that she lives from adequate medical care and the possibility for recurrent severe reactions, the patient will be hospitalized for further observation. 12-23 Female with history of asthma and addison''s had anaphylaxis to covid vaccine. Admitted over night to ensure that she did not rebound. Received IV Dex and this am has had no reoccurrence of hives or shortness of breath. Will discharge home on epipen, hydrocortisone prn, prednisone bid for 5 days. Return to ER or go to PCP for worsening symptoms.


Changed on 5/7/2021

VAERS ID: 907616 Before After
VAERS Form:2
Age:53.0
Sex:Female
Location:New Mexico
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 - / IM

Administered by: Other      Purchased by: ??
Symptoms: Anaphylactic reaction, Dyspnoea, Hypersensitivity, Pruritus, Urticaria

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)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Past Medical History: Diagnosis Date ? Addison''s disease (CMS-HCC) 03/2015 ? Asthma (CMS-HCC) ? Disorder of thyroid (CMS-HCC)
Allergies: meperidine, morphine=anaphylaxis flagyl=pancreatitis flagyl=pancreatitis
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12-22 HPI 53-year-old female with a history of Addison''s disease, anaphylactic reaction who presents to the ED complaining of hives and shortness of breath. Patient reports that 3 days ago she received the COVID-19 pfizer vaccine. She reports that since that time she has developed progressively worsening hives on her legs and arms. Approximately 1 hour ago she began to develop shortness of breath and so she presented to the ER. Patient reports a previous history of anaphylactic reactions multiple times. Denies any other acute complaints at this time. MDM Patient came in with shortness of breath and hives. Suspect allergic reaction to the COVID-19 vaccine. Patient had already taken 50 mg of Benadryl. She was given Solu-Medrol and EpiPen. She reported feeling better with improvement in the pruritus. She reports that she has had rebound reaction requiring EpiPen at 24 hours. Given the distance that she lives from adequate medical care and the possibility for recurrent severe reactions, the patient will be hospitalized for further observation. 12-23 Female with history of asthma and addison''s had anaphylaxis to covid vaccine. Admitted over night to ensure that she did not rebound. Received IV Dex and this am has had no reoccurrence of hives or shortness of breath. Will discharge home on epipen, hydrocortisone prn, prednisone bid for 5 days. Return to ER or go to PCP for worsening symptoms.


Changed on 5/14/2021

VAERS ID: 907616 Before After
VAERS Form:2
Age:53.0
Sex:Female
Location:New Mexico
Vaccinated:2020-12-18
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK5730 / 1 - / IM

Administered by: Other      Purchased by: ??
Symptoms: Anaphylactic reaction, Dyspnoea, Hypersensitivity, Pruritus, Urticaria

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)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Past Medical History: Diagnosis Date ? Addison''s disease (CMS-HCC) 03/2015 ? Asthma (CMS-HCC) ? Disorder of thyroid (CMS-HCC)
Allergies: meperidine, morphine=anaphylaxis flagyl=pancreatitis flagyl=pancreatitis
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12-22 HPI 53-year-old female with a history of Addison''s disease, anaphylactic reaction who presents to the ED complaining of hives and shortness of breath. Patient reports that 3 days ago she received the COVID-19 pfizer vaccine. She reports that since that time she has developed progressively worsening hives on her legs and arms. Approximately 1 hour ago she began to develop shortness of breath and so she presented to the ER. Patient reports a previous history of anaphylactic reactions multiple times. Denies any other acute complaints at this time. MDM Patient came in with shortness of breath and hives. Suspect allergic reaction to the COVID-19 vaccine. Patient had already taken 50 mg of Benadryl. She was given Solu-Medrol and EpiPen. She reported feeling better with improvement in the pruritus. She reports that she has had rebound reaction requiring EpiPen at 24 hours. Given the distance that she lives from adequate medical care and the possibility for recurrent severe reactions, the patient will be hospitalized for further observation. 12-23 Female with history of asthma and addison''s had anaphylaxis to covid vaccine. Admitted over night to ensure that she did not rebound. Received IV Dex and this am has had no reoccurrence of hives or shortness of breath. Will discharge home on epipen, hydrocortisone prn, prednisone bid for 5 days. Return to ER or go to PCP for worsening symptoms.

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