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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 2397848 |
VAERS Form: | 2 |
Age: | 12.0 |
Sex: | Female |
Location: | Florida |
Vaccinated: | 2022-01-13 |
Onset: | 2022-02-02 |
Submitted: | 0000-00-00 |
Entered: | 2022-08-01 |
Vaccination / Manufacturer (2 vaccines) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | - / UNK | AR / SYR |
FLUC4: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT) / SEQIRUS, INC. | - / UNK | AR / SYR |
Administered by: Pharmacy Purchased by: ??
Symptoms: Angioedema, Laboratory test, Chronic spontaneous urticaria
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flu Vaccine taken same day as Pfizer booster on 1/13/2022
Current Illness: Tardive Dyskinesia , Psychosis
Preexisting Conditions: ASD, ADHD, Schizoaffective Disorder, PTSD, DMDD, Developmental Delays, Chung Jansen Syndrome, MTHFR
Allergies: Gluten, Dairy, Lithium, Saphris
Diagnostic Lab Data: Rheumatologist ordered labs to confirm autoimmune urticaria and angioedema 4/14/2022
CDC 'Split Type':
Write-up: Chronic Autoimmune Urticaria daily since the begin of February, full body Angioedema sporadically since May, facial mostly eyes and lips
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