VAERS ID: 903016

AGE: 54| SEX: F|STATE: (United States)

Description

Approximately 11 minutes after receiving the vaccine, the patient complained of shortness of breath, tingling in arms and hands, numbness and tingling in legs and feet, and was observably shaking, with no complaints of swelling in throat or other signs of anaphylaxis. Patient was brought to ER in same facility via stretcher and was examined by staff there. ER report states the patient presented with shortness of breath and what appeared to be a panic attack, with fast breathing, slight flushing, and shaking. Per ER report, the patient was treated for an acute anaphylactic reaction, with clear lungs and given an EpiPen shot in the right thigh. IV was initiated and given a fluid bolus, solu medrol, famotidine, and lorazepam. Labs and a chest x-ray done and reviewed. After treatment, patient found to be stable and was discharged home at 4:42 pm with orders for famotidine, albuterol inhaler, and epinephrine pen.

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Symptoms

Dyspnoea, Paraesthesia, Tremor, Hypoaesthesia, Anaphylactic reaction, Laboratory test, Chest X-ray, Flushing, Respiratory rate increased, Panic attack

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:12-17-2020
RPT_DATE:
CAGE_YR:54
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:
V_ADMINBY:PVT
OTHER_MEDS:
CUR_ILL:
HISTORY:migraine, obstructive sleep apnea
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-17-2020
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:clindamycin, clotrimazole, dihydroergotamine, IV contrast medium, prochlorperazine, promethazine, sumatriptan
V_FUNDBY:

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