Adverse Event Reporting
| VAERS ID | 907022 |
|---|---|
| Gender | Female |
| Age | 44 |
| StateCode | OH |
| Pharmaceutical Company | MODERNA |
| Lot Number | 011J20A |
| Number of vaccinations | 1 |
| Vaccinated | 2020-12-22 |
| Onset | 2020-12-22 |
| Condition | Hospitalized Life Threatening |
Symptoms
- Angioedema
- Anaphylactic reaction
- Endotracheal intubation
Current Illness
Not known
Preexisting Conditions
Anxiety; Depression; Chronic Back Pain
Other Medications
Calcium 600 mg with D daily; Women's Multiple vitamin daily; Vitamin D3 5,000 units daily; Zyrtec 10 mg at bedtime PRN; Celebrex 200 mg daily; Gabapentin 300 mg (3 caps daily); Melatonin 9 mg daily PRN; Zanaflex 4 mg Daily
Previous Vaccinations
Allergies
Morphine; Tramadol; NSAIDs; Codeine; Oxycodone; Percocet
Laboratory Data
None at this time
Write-up
Anaphylaxis/Angioedema Patient was given EpiPen 0.
3 mg IM; Methylprednisolone 125 mg once; Diphenhydramine 25 mg IV push once; Famotidine 20 mg IV push once; Dexamethasone 10 mg IV push once Patient was intubated and put on propofol and midazolam drips for sedation