VAERS ID: 1880559

AGE: 17| SEX: F|STATE: WI (United States)

Description

Patient was brought to emergency room at Medical Center at midnight the night after receiving the vaccine, with rash and difficulty breathing. Per parent, steroids were given and and IV was started. Patient was brought to Medical Center Clinic on 11/17/21 for numbness and tingling in bilateral upper and lower extremities. Was instructed to take Benadryl. Numbness and tingling has improved somewhat and has not progressed since starting Benadryl.

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Symptoms

Rash, Dyspnoea, Paraesthesia, Hypoaesthesia

Vaccines

VAX DATE: 11-16-2021| ONSET DATE: 11-17-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH FG3527 IM LA

RECVDATE:11-18-2021
RPT_DATE:
CAGE_YR:17
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:Contact Medical Center for treatment details.
V_ADMINBY:PUB
OTHER_MEDS:NONE
CUR_ILL:NONE
HISTORY:NONE AT THE TIME, ASTHMA AS A CHILD
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:11-18-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:Y
ALLERGIES:NONE
V_FUNDBY:

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