Adverse Event Reporting
| VAERS ID | 931772 |
|---|---|
| Gender | Female |
| Age | 30 |
| StateCode | OH |
| Pharmaceutical Company | MODERNA |
| Lot Number | 039K20A |
| Number of vaccinations | 1 |
| Vaccinated | 2021-01-07 |
| Onset | 2021-01-07 |
| Condition | Life Threatening Recovered |
Symptoms
- Anaphylactic reaction
Current Illness
none
Preexisting Conditions
Had COVID 19 diagnosed October 2020
Other Medications
OTC multi-vitamin
Previous Vaccinations
Allergies
Ambien-visual hallucination Bee/wasp venom (localized swelling)
Laboratory Data
Treated urgently in facility and then transferred to local ED same day
Write-up
Anaphylaxis