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This is VAERS ID 909607

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 909607
VAERS Form:2
Age:41.0
Sex:Female
Location:Connecticut
Vaccinated:2020-12-18
Onset:2020-12-22
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 5/7/2021

VAERS ID: 909607 Before After
VAERS Form:2
Age:41.0
Sex:Female
Location:Connecticut
Vaccinated:2020-12-18
Onset:2020-12-22
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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 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.


Changed on 5/14/2021

VAERS ID: 909607 Before After
VAERS Form:2
Age:41.0
Sex:Female
Location:Connecticut
Vaccinated:2020-12-18
Onset:2020-12-22
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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 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.

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


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