VAERS ID: 902758

AGE: 43| SEX: M|STATE: AK (United States)

Description

@ ~5 min felt cotton mouth. Got up to ask if he could go early. Then at 10 min post injection, felt eyes feeling weird and he felt "high". As in lightheaded. @ 10 min, skin surrounding the eyes are puffy. Given 25 mf benedryl. No immediate SOB or wheeze. No lip or mouth or throat swelling. Taken to ED. Given IM epi 1:1000 0.3ml. Pepcid and more benedryll PO.

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Symptoms

Dizziness, Dry mouth, Euphoric mood, Blood test, Abnormal sensation in eye, Periorbital swelling

Vaccines

VAX DATE: 12-16-2020| ONSET DATE: 12-16-2020| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EK5730 IM LA

RECVDATE:12-16-2020
RPT_DATE:
CAGE_YR:43
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:blood drawn. un sure of test ordered.
V_ADMINBY:PVT
OTHER_MEDS:MVI- generic brand
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-16-2020
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:
V_FUNDBY:

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