National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/26/2021 release of VAERS data:

This is VAERS ID 909607

Government Disclaimer on use of this data



Case Details

VAERS ID: 909607 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2020-12-18
Onset:2020-12-22
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2020-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK 5730 / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction, Erythema, Hypotension, Pruritus, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cymbalta Ubrevly prn Fioricet prn Desensitization injections
Current Illness: migraine headaches
Preexisting Conditions: migraine headaches environmental allergies
Allergies: Environmental allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Received Pfizer COVID-19 vaccine without untoward effects on 12/18. Given her usual allergy shot by her allergist on 12/22 (she has been receiving these for several years; I was told this is a protein antigen in a glycerine suspension). Within 15 minutes, patient developed anaphylaxis: generalized erythema, swelling, pruritus and hypotension requiring epinephrine, and diphenhydramine. Patient recovered over several hours.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=909607


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