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VAERS ID: 1874149

AGE: 8| SEX: F|State: MD

Description

15 Min post pediatric Pfizer vaccination, patient had a hive reaction on her face and hands and reported her ?throat was itchy?. RN administered 25mg IM Benadryl. 911 was called while VS were taken. BP 104/80 HR 83 Regular, SpO2 100%, RR 16. No breathing difficulties noted. Patient was observed and stated she stated felt a lot better . EMS arrived. Report and care of patient transferred to EMS. EMS recommended patient should go to the ER, however Mother refused and stated she would prefer to take her daughter to doctor.

Symptoms

Throat irritation, Urticaria

Vaccines

VAX DATE: 14 November 2021 | ONSET DATE: 14 November 2021 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 1
  • IM
  • RA
  • FK5127

RECVDATE:15 November 2021
CAGE_YR:8
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:Y
LAB_DATA:VS taken prior to EMS arrival
V_ADMINBY:SCH
OTHER_MEDS:Unknown
CUR_ILL:None
HISTORY:None
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:15 November 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:None Mom reported
V_FUNDBY:
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