National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

From the 1/14/2022 release of VAERS data:

This is VAERS ID 906321

Government Disclaimer on use of this data



Case Details

VAERS ID: 906321 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Colorado  
Vaccinated:2020-12-17
Onset:2020-12-21
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2020-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / UNK UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Middle insomnia, Oedema, Swollen tongue, Tongue discomfort
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanz
Current Illness: None
Preexisting Conditions: None
Allergies: No known drug allergies
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Woke up in the middle of the night on 12/20 and noticed that the left side of tongue felt like he had bit it. He woke up again on 12/21 at 1:10 AM with a swollen tongue. He also had left sided unilateral edema. NKDA or significant past medical history. No past allergic reactions. Went to the ED and was treated with benadryl and a methylprednisone. Sent home with additional medications in case condition worsened again.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=906321


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166