Report #2869563

Received Oct 30, 2025

HospitalizedER / ED 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: 40 yrs
State: WA
Recovered: Recovered
Vaccinated: Oct 20, 2025
Onset: Oct 20, 2025
Days to onset: 0
Hospital days: —

Vaccines (4)

Type	Name	Manufacturer	Dose	Lot	Route / Site
FLU3	INFLUENZA (SEASONAL) (FLUCELVAX)	SEQIRUS, INC.	UNK	410515	LA
HEP	HEP B (HEPLISAV-B)	DYNAVAX TECHNOLOGIES CORPORATION	UNK	946913	LA
IPV	POLIO VIRUS, INACT. (IPOL)	SANOFI PASTEUR	UNK	y1d03p1	LA
TDAP	TDAP (BOOSTRIX)	GLAXOSMITHKLINE BIOLOGICALS	UNK	k4979	IM / LA

Symptoms (6)

Anaphylactic reactionAnaphylaxis treatmentDyspnoeaPharyngeal swellingRetchingSwollen tongue

Symptom narrative

Anaphylaxis a few minutes after administration. symptoms included difficulty breathing, swollen throat/tongue and gagging. Administered epi-pen twice. Emergency arrived and administered another epinephrine dose.

Medical history

Asthma

Allergies

Lamictal, imitrex, covid vaccines

Prior vaccinations

Moderna, last shot on March 13, 2022. Said she had allergic reaction to it.