VAERS Explorer
Back to explore

Report #2838248

Received Apr 28, 2025

ER / ED visitOffice visit
A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex
Female
Age
69 yrs
State
KS
Recovered
Not recovered
Vaccinated
Dec 18, 2023
Onset
Dec 28, 2024
Days to onset
376
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA3——

Symptoms (6)

Biopsy skinBlisterBlood immunoglobulin GDermatitisEosinophiliaPathology test

Symptom narrative

onset of serology positive bullous pemphigoid 10 days following vaccine administration

Current illness

n/a

Medical history

HTN, GERD, Insomnia, Vitamin D deficiency

Other medications

Atenolol, Atorvastatin, HCTZ, Losartan, Lysine, Melatonin, Pantoprazole, Vitamin D3

Allergies

Codeine, Meloxicam, Penicillin, Sulfa, Vancomycin

Lab data

Punch Biopsy 01/05/2024: negative IFA; pathology positive for subepidermal blister with superficial and deep chronic inflammation with eosinophils. 7/23/2024: BP180 IgG 123 RU/mL; BP230 IgG 13 RU/mL