Adverse Event Reporting
| VAERS ID | 913445 |
|---|---|
| Gender | Female |
| Age | 24 |
| StateCode | |
| Pharmaceutical Company | MODERNA |
| Lot Number | |
| Number of vaccinations | 1 |
| Vaccinated | 2020-12-27 |
| Onset | 2020-12-27 |
| Condition | Hospitalized Life Threatening |
Symptoms
- Chest discomfort
- Intensive care
- Lip swelling
- Pruritus
- Urticaria
- Anaphylactic reaction
Current Illness
Preexisting Conditions
Other Medications
Previous Vaccinations
Influenza vaccine = hives
Allergies
Pt reports having hives to the influenza vaccine
Laboratory Data
Write-up
Pt developed anaphylaxis, was given IM Benadryl, and was sent to the ED.
Pt spent 1 night in the hospital, went home, and has come back and is in the ICU.
Pt had hives, itching, chest tightness, swollen lips.