VAERS ID: 1761186

AGE: 17| SEX: F|STATE: FR (Unknown)

Description

tachycardia; allergic episode; no movements; swelling of the glottis; atrophied hands and feet with no blood circulation; wheezing; breathlessness; itching on throat; swollen mouth; body completely taken by redness; This is a spontaneous report from a contactable consumer (patient) via regulatory authority. A 17-year-old female (not pregnant) patient received the first dose of BNT162B2 (COMIRNATY) via an unspecified route of administration on the left arm on 30Aug2021 at 16:45 (Batch/Lot Number: 28231BD) at the age of 17-year-old as single dose for COVID-19 immunization. Medical history included chronic asthma with medication release from Jun2020 and allergic episode from 2019. The patient didn't received other vaccine within 4 weeks prior to the COVID-19 vaccine. The patient didn't received other medications within 2 weeks of vaccination. Prior to vaccination, the patient wasn't diagnosed with COVID-19. Since the vaccination, the patient hadn't been tested for COVID-19. Patient presented allergic episode two years ago, and after performing over 200 tests, nothing was found. Concomitant medication was none. On 30Aug2021 at 05:00 PM, the patient was with body completely taken by redness, itching on throat, swollen mouth. At 18:00, when admitted in the hospital emergency, she was already presented wheezing and breathlessness. There were applied medications to reverse the allergic episode that momentarily worsened, letting her with atrophied hands and feet with no blood circulation, tachycardia and no movement, she stayed under observation until 2:00 am the next day. The doctor described it as swelling of the glottis, which was removed with more medications applied. The events resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care, hospitalization and Life threatening illness (immediate risk of death from the event). Treatment was received included intravenous and intramuscular medications. The outcome of events was resolved with sequel.

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Symptoms

Dyspnoea, Hypersensitivity, Tachycardia, Paralysis, Laryngeal oedema, Erythema, Wheezing, Throat irritation, Heart rate, Poor peripheral circulation, Mouth swelling

Vaccines

VAX DATE: 08-30-2021| ONSET DATE: 08-30-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH 28231BD LA

RECVDATE:10-05-2021
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:Y
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:1
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:Test Name: tachycardia; Result Unstructured Data: Test Result:increase
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:Medical History/Concurrent Conditions: Allergy; Asthma chronic
PRIOR_VAX:
SPLTTYPE:BRPFIZER INC202101288474
FORM_VERS:
TODAYS_DATE:10-04-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:Y
ALLERGIES:
V_FUNDBY:

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