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Report #2865400

Received Oct 13, 2025

Office 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
Male
Age
77 yrs
State
CA
Recovered
Recovered
Vaccinated
Oct 1, 2025
Onset
Oct 1, 2025
Days to onset
0
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (PFIZER-BIONTECH))PFIZER\BIONTECH1my9547IM / LA

Symptoms (8)

Back painEye swellingMouth swellingRashRash macularSwelling faceSwollen tongueTenderness

Symptom narrative

Systemic: Allergic: Rash (specify: facial area, extremeties)-Severe, Systemic: Allergic: Rash Generalized-Severe, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Medium, Systemic: back pain-Severe, Additional Details: gradual symptom onset 10/01: 8p lower back pain resolved with tylenol/cod 10/02: jaw swollen, tender and pink dots on lower back area 10/03:pink dots spread to front of chest and size increase 10/04: pink dots increased in size and covered all body except face 10/05: spots increased in size and spotchy, meshed together as generalized rash. 10/06 pt made appt with doc confirming side effect to vaccine

Allergies

n/a