VAERS ID: 902465

AGE: 60| SEX: F|STATE: AR (United States)

Description

Pt felt wave come over body @ 1218 starting in head and going down. Bad taste in mouth, tingling in body , legs, back , across stomach, BP 150/100 P 120@ 1219, EMS activated. BP 120/80, P 80 Pt alert and oriented, Pt declined transport and Benadryl. Symptoms come and go, pt feels better but then bad taste in mouth starts, shaking of hands, tingling starts again in stomach and back. @ 1300 pt requests Benadryl, 25 mg administered. Pt notified family by phone of circumstances and family in transit.@1324 BP 120/80, P 84, tongue tingling and pt reports smelling chemical smell. @1345 Pt complained of mouth itching, EMS activated and will transport to Medical Center. Pt oriented and transported at @13

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Symptoms

Paraesthesia, Tremor, Dysgeusia, Paraesthesia oral, Parosmia, Sensory disturbance, Oral pruritus

Vaccines

VAX DATE: 12-15-2020| ONSET DATE: 12-15-2020| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EH9899 IM RA

RECVDATE:12-15-2020
RPT_DATE:
CAGE_YR:60
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:BP.
V_ADMINBY:PUB
OTHER_MEDS:Lisinopril, HCTZ, lipitor, amyitrypline, lexapro, vitamins,
CUR_ILL:Bronchitis, finished prednisone on 12-13-20
HISTORY:hypertension, fibromyalgia
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-15-2020
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:Biaxin
V_FUNDBY:

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