VAERS ID: 1864543

AGE: 24| SEX: F|STATE: OK (United States)

Description

Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: Patient reported an itchy/tingling sensation on her tongue. Gave her water and 50mg of Benadryl and monitored for 30 minutes. She reported that it may have been nerves and "hyperchondriac" feeling. Patient was fine a few minutes later and for the duration of observation

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Symptoms

Pruritus, Paraesthesia, Paraesthesia oral, Tongue pruritus

Vaccines

VAX DATE: 11-11-2021| ONSET DATE: 11-11-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 3 COVID19 MODERNA 033F21A SYR LA

RECVDATE:11-12-2021
RPT_DATE:
CAGE_YR:24
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:
V_ADMINBY:PHM
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:11-12-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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