Sex: F
Vaccine: COVID19
Symptoms: Swelling face, Swollen tongue, Tongue discomfort, Wheezing
Clinical narrative: tongue was swollen again and blocking her airway.; tongue was swollen again and blocking her airway.; upper pallet was swollen as well along with the uvula.; wheezing as well; tongue was swollen again; swollen face and tongue, it was red and itchy,; swollen face and tongue, it was red and itchy,; swollen face and tongue, it was red and itchy,; swollen face and tongue, it was red and itchy,; swollen around her eye sockets.; three separate anaphylactic reactions; metallic taste in her mouth; tongue started swelling up; trouble swallowing.; stinging, burning, tingling sensation from the back of her tongue to the tip of her tongue as if she had gargled with peroxide; stinging, burning, tingling sensation from the back of her tongue to the tip of her tongue as if she had gargled with peroxide; stinging, burning, tingling sensation from the back of her tongue to the tip of her tongue as if she had gargled with peroxide; A spontaneous report was received from a nurse concerning a 53-year-old, female patient who developed three separate anaphylactic reactions.   The patient's medical history included asthma. Products known to have been used by the patient, within two weeks prior to the event, included lisinopril.  On 26 Jan 2021, approximately 26 minutes prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (Batch number not provided) intramuscularly in the left arm for prophylaxis of COVID-19 infection.    26 Jan 2021, the patient experienced three separate anaphylactic reactions afterwards. About 26 minutes after receiving her vaccine, she first felt a metallic taste in her mouth and then her tongue started swelling up and she had trouble swallowing. She had no trouble breathing though. She felt a stinging, burning, tingling sensation from the back of her tongue to the tip of her tongue as if she had gargled with peroxide. She went to the ER and was given 15 mg IV Benadryl.  On 27Jan2021, less than 10 hours after her original reaction, she woke up in the early morning and her tongue was swollen again. She had a swollen face and tongue, it was red and itchy, and it was swollen around her eye sockets. She had no difficulty breathing. She went to the ER and was given EpiPen and Decadron IV push.  On 05Feb2021, she had a delayed type of anaphylactic reaction. Her tongue was swollen again and blocking her airway. The upper pallet was swollen as well along with the uvula. She was wheezing as well and she took Symbicort and Xopenex rescue inhaler. She also has asthma. She took EpiPen, 50 mg oral Benadryl, and Decadron IV ER. She described this as the worst reaction. Out of all three of her reactions. Her ER doctor said she was reacting to her lisinopril medication that she has been on for 10 years while her PCP says she is reacting to the vaccine.  Treatment for the event included 15 mg IV Benadryl, Epipen and Decadron IV push, EpiPen, 50 mg oral Benadryl, and Decadron IV ER.  Action taken with mRNA-1273 in response to the events was not reported.  The outcome of the events were unknown.; Reporter's Comments: This case concerns a 53-year-old female with 3 serious expected anaphylactic reactions, with unexpected dysgeusia, dysphagia, enlarged uvula, swollen tongue, tongue discomfort, glossodynia, oral paraesthesia, swollen face/eyes, erythema, pruritus, obstructive airway disorder, wheezing.  Event onset same day as first dose. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.