Adverse Event Reporting

VAERS ID 909061
Gender Female
Age 66
StateCode OH
Pharmaceutical Company MODERNA
Lot Number G39K202A
Number of vaccinations 1
Vaccinated 2020-12-24
Onset 2020-12-24
Condition Life Threatening Recovered
Symptoms
  • Blood pressure increased
  • Swollen tongue

Current Illness

Preexisting Conditions

hypertension

Other Medications

Lipitor, Maxide-25, Cymbalta, ASA

Previous Vaccinations

Allergies

Codeine, PCN, Promethazine, sulfa antibiotics

Laboratory Data

Write-up

Reported sensation of tongue swelling during post-vaccination observation at 10 minutes.
Epinephrine was refused and she was taken to ED for observation where she was given oral dose of Benadryl and Pepcid.
Discharged with instructions to return PRN and follow up with PCP.
Elevated BP noted.