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From the 1/7/2022 release of VAERS data:

Found 6,644 cases where Vaccine is COVID19 and Manufacturer is MODERNA and Symptom is Cerebral venous sinus thrombosis or Cerebral venous thrombosis or Coagulopathy or Deep vein thrombosis or Disseminated intravascular coagulation or Embolism or Idiopathic thrombocytopenic purpura or Immune thrombocytopenia or Immune thrombocytopenic purpura or Ischaemic stroke or Myocardial infarction or Petechiae or Pulmonary embolism or Purpura or Thrombocytopenia or Thrombosis or Vasculitis

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Case Details

This is page 29 out of 665

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VAERS ID: 1056972 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-01-29
Onset:2021-02-04
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Acute myocardial infarction, Antiphospholipid syndrome, Atrial fibrillation, Biliary dilatation, Cerebrovascular accident, Diarrhoea, Dysphagia, Electrocardiogram QT prolonged, Encephalopathy, Endoscopy, Gastrointestinal oedema, Hepatic cirrhosis, Imaging procedure, Intestinal angioedema, Intestinal mass, Intracranial mass, Laboratory test, Leukocytosis, Malaise, Oesophageal varices haemorrhage, Peritonitis bacterial, Supraventricular tachycardia, Thrombosis
SMQs:, Torsade de pointes/QT prolongation (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Conduction defects (narrow), Supraventricular tachyarrhythmias (narrow), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Retroperitoneal fibrosis (broad), Torsade de pointes, shock-associated conditions (narrow), Pseudomembranous colitis (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal perforation (narrow), Gastrointestinal haemorrhage (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Thrombophlebitis (broad), Biliary tract disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-02-27
   Days after onset: 23
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen
Current Illness:
Preexisting Conditions: Depression Hyperlipidemia Anxiety disorder Elevated BP without diagnosis of hypertension Alcohol abuse Osteopenia Tubular adenoma of colon Serrated adenoma of colon Cyst of left breast
Allergies: Ampicillin-nausea
Diagnostic Lab Data: Pt. has had multiple lab tests, imaging studies, endoscopic procedures. Too numerous to list here. Current Hospital diagnoses as of 02/26/2021 Hospital SVT (supraventricular tachycardia) Thrombus Acute encephalopathy Dysphagia, unspecified Non-ST elevation (NSTEMI) myocardial infarction Prolonged Q-T interval on ECG Leukocytosis A-fib Common bile duct dilation Duodenal mass Cirrhosis Small bowel edema Stroke Bleeding esophageal varices SBP (spontaneous bacterial peritonitis) Catastrophic antiphospholipid syndrome
CDC Split Type:

Write-up: 5-6 days after receiving first Moderna covid vaccine pt. began not feeling well. On 02/10/2021 she saw a provider in an office for eval of abdominal pain and diarrhea and sent home. On 02/15/2021 she presented to a local ED with continuing symptoms, transferred to Medical Center. She is currently an inpatient there with a diagnosis of multiple blood clots in abdomen and brain and antiphospholipid syndrome.


VAERS ID: 1057057 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-20
Onset:2021-02-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Blood grouping, Contusion, Crossmatch, Full blood count, Laboratory test, Metabolic function test, Petechiae, Platelet count decreased, Prothrombin level, Prothrombin time
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Alopurinol, Amlodipine, Hydralazine, Levothyroxine, Lisinopril, Omeprazole, OTC multivitamin, Vitamin B-12, and Vitamin D
Current Illness: None
Preexisting Conditions: Hypothyroidism, Stage 3 Kidney Disease, and Hypertension
Allergies: Shrimp, Molds and Mildrew, Hives with Zocar/Zetia/Liptor
Diagnostic Lab Data: 02/25/2021 CBC, PT, PTT, CMP, blood and cross match
CDC Split Type:

Write-up: Petechia and bruising appeared approximately 2 days after receiving the Covid-19 Moderna vaccine. Patient was hospitalized for excessive petechia and bruising in bilateral lower extremities with platelet count of 2,000.


VAERS ID: 1057548 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-01-02
Onset:2021-01-30
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20-2A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Atelectasis, Back pain, Chest pain, Chills, Computerised tomogram, Deep vein thrombosis, Fibrin D dimer, Myalgia, Pain in extremity, Pleural effusion, Prothrombin time prolonged, Pulmonary embolism, Pulmonary infarction, Pyrexia, SARS-CoV-2 test, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (broad), Liver-related coagulation and bleeding disturbances (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (Medical history not provided)
Allergies:
Diagnostic Lab Data: Test Date: 20210205; Test Name: CT scan; Result Unstructured Data: Bilateral pulmonary embolism and multiple areas of infarct along with atelectasis; Test Date: 202102; Test Name: CT scan; Result Unstructured Data: pulmonary embolism not progressing; positive for pulmonary effusions (second CT completed 2 days s/p hospital discharge); Test Date: 20210205; Test Name: D-dimer; Result Unstructured Data: 4800; Test Date: 202102; Test Name: PTT; Result Unstructured Data: increased after coagulation; Test Date: 20210205; Test Name: Covid-19; Result Unstructured Data: negative; Test Date: 202102; Test Name: Covid-19; Result Unstructured Data: negative; Test Date: 20210205; Test Name: ultrasound of the legs; Result Unstructured Data: Ultrasound of legs negative for deep vein thrombosis; Test Date: 202102; Test Name: ultrasound of the legs; Result Unstructured Data: Utrasound of legs positive for deep vein thrombosis
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: bilateral pulmonary embolism; multiple areas of infarct; back pain; ateltheisis; chest pain; left leg pain; deep vein thrombosis; pulmonary effusions; fever; Chills; myalgia; A spontaneous report was received from a physician who was also a 55-year-old, previously healthy male patient who received Moderna''s COVID-19 vaccine (mRNA-1273) and experienced fever/pyrexia, chills, myalgia, chest and back pains, bilateral pulmonary embolism/pulmonary embolism, multiple areas of infarct/pulmonary infarct, ateltheisis/atelectasis, left leg pain, and deep vein thrombosis. The patient''s medical history included daily exercise and no personal or family history of clotting issues and no trauma. Products known to have been used by the patient were not provided. On 02 Jan 2021, prior to the onset of the events, the patient received the first of two planned doses of mRNA-1273 (Lot number: 039k20-2a) intramuscularly for prophylaxis of COVID-19 infection. On 30 Jan 2021, approximately 28 days after the first dose, and prior to the onset of symptoms, the patient received the second of two planned doses of mRNA-1273 (Lot number: 012m20a) intramuscularly for the prophylaxis of COVID-19 infection. On 30 Jan 2021, the patient reports that for the first 18 hours, he experienced fever, chills and myalgia. On 01 Feb 2021, the patient reports that he thought the myalgia was continuing, as he had pain in his chest and back. The chest pains gradually worsened. On 05 Feb 20221, the patient went to the emergency room and was admitted. He was diagnosed with a pulmonary embolism. He was started on enoxaparin sodium but switched to apixaban. A computerized tomography study of the lungs showed that he had bilateral pulmonary embolism, multiple areas of infarct and atelectasis. His dimer was 4800. COVID-19 test was negative. An echocardiograph was performed, no results were reported. An ultrasound of the legs was performed and ruled out deep vein thrombosis. Date of discharge was not specified. On an unknown date two days after discharge, the patient experienced left leg pain and returned to the emergency department. Patient was diagnosed with deep vein thrombosis that ran the entire length of the femoral artery. Patient was switched back to enoxaparin sodium and taken off the apixaban. A repeat computerized tomography study was done to see if the pulmonary embolism was progressing and it was not, however, it showed pulmonary effusions. All current lab work was reported as normal, except for an increased prothrombin time. COVID-19 test was negative. Patient continues to be followed by a pulmonologist and hematologist. Consent to contact patient, pulmonologist and hematologist was obtained. Action taken with mRNA-1273 was not applicable. The outcome of the events, fever/pyrexia, chills, myalgia, chest and back pains, bilateral pulmonary embolism/pulmonary embolism, multiple areas of infarct/pulmonary infarct, ateltheisis/atelectasis, left leg pain, and deep vein thrombosis, was considered not resolved.; Reporter''s Comments: Very limited information regarding this events has been provided at this time. Further information has been requested. Company assessed the events to be unlikely related to company product.


VAERS ID: 1057713 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-01-05
Onset:2021-02-09
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Contusion, Full blood count, Haemorrhage, Immune thrombocytopenia, Laboratory test, Metabolic function test, Petechiae, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Plaquenil
Current Illness:
Preexisting Conditions: Mixed Connective Tissue Disease, Sjogrens, Antiphospholipid Disease, Rheumatoid Arthritis, ITP
Allergies: None
Diagnostic Lab Data: CBC, CMP on: 2/9/2021, 2/10/2021, 2/11/2021, 2/12/2021, 2/13/2021, 2/14/2021, 2/15,2021, 2.16.2021, 2/17/2021, 2/18/2021, 2/22/2021, and 2/25/2021.
CDC Split Type:

Write-up: Extreme ITP, platelets <1,000, spontaneous bleeding, bruising, petechiae


VAERS ID: 1057786 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-01-26
Onset:2021-01-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Deep vein thrombosis, Limb discomfort, Pain in extremity, Plasminogen activator inhibitor, Sensory disturbance, Stent placement, Thrombosis, Vascular operation, Vena cava filter insertion
SMQs:, Peripheral neuropathy (narrow), Haemorrhage laboratory terms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Valsartan/HCTZ Celexa Singulair Carvedilol Zyrtec
Current Illness: Sinus Infection
Preexisting Conditions: HTN Sinus Infections
Allergies: N/A
Diagnostic Lab Data: Heparin Drip, TPA and surgery was performed. A stent was placed, as well as an IVC filter. I am currently on blood thinners to prevent anymore clots from forming and am following up with Hematology and Vascular Surgery.
CDC Split Type:

Write-up: Within 12 hours of receiving my second vaccine, My left leg felt like it internally rotated and started to hurt and feel like lead. On January 28, 2021, I went to the ER and an extensive blood clot (DVT) was found.


VAERS ID: 1057801 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-02-06
Onset:2021-02-19
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Faeces discoloured, Immune thrombocytopenia, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin, bumetanide, carvedilol, Entresto, fish oil, garlic, metformin, MVI, Nexium, KCl, tamsulosin, Vit C, Osteo-Biflex
Current Illness: none
Preexisting Conditions: Type 2 DM, CAD, HTN, obesity, NAFLD
Allergies: PCN
Diagnostic Lab Data: platelet count 2000
CDC Split Type:

Write-up: Patient noted dark stools and presented to office 2/23/2021. ITP with platelet count of 2K. Successfully treated with standard dexamethasone dosing. No adverse complications. Has a hx of ITP presumed due to viral infection in 2016.


VAERS ID: 1058144 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-02-04
Onset:2021-02-06
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Haemoptysis, Nasopharyngitis, Vaccination complication, Vasculitis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad), Vasculitis (narrow), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ELIQUIS
Current Illness: AFib
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: vasculitis; coughing up blood; really bad head cold; dizzy; Started gettting sick; A spontaneous report received from a Consumer concerning, 79-year-old, female patient who received dose of Moderna COVID-19 vaccine experienced Vasculitis. The patient''s medical history included Afib. Patient''s concomitant included Eliquis. On 04FEB2021, the patient received their 1st dose of the two planned doses of mRNA-1273 in left arm (Batch #: unknown) intramuscularly for prophylaxis of COVID-19 infection. Patient daughter reports her mother who is 79-year-old female with no underlining health issues other than Afib, which she takes blood thinners for has been in ICU since 10FEB2021. Patient daughter stated that she was told her mother has vasculitis as a result of the Moderna Covid-19 vaccine. Patient daughter stated that her mother started getting sick on 06Feb2021. She stated her mother started coughing up blood on Sunday 07FEB2021. She stated her mother also had a bad head cold and was dizzy. Patient daughter stated that her mother has some genetic predisposition and the Moderna COVID-19 vaccine triggered it. Patient daughter stated that her mother doctor advised her not to receive the 2nd dose of the Moderna COVID-19 vaccine. Patient treatment included Chemotherapy Infusion (Rituxan) and Blood Transfusion. Action taken with mRNA-1273 in response to the event was withdrawn. The outcome of the event was unknown/not reported.; Reporter''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1058166 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-02-25
Onset:2021-02-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Ischaemic stroke
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No Known illnesses
Preexisting Conditions: HTN, Bipolar
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Acute ischemic stroke


VAERS ID: 1058358 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-02-23
Onset:2021-02-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 2 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Abdominal distension, Aortic valve incompetence, Atrial enlargement, Back pain, Blood folate, Brain natriuretic peptide increased, Cardiac failure acute, Cardiac failure congestive, Cellulitis, Chest X-ray abnormal, Chest X-ray normal, Compression fracture, Computerised tomogram abdomen, Computerised tomogram abdomen abnormal, Computerised tomogram head normal, Computerised tomogram pelvis abnormal, Dyspnoea, Echocardiogram abnormal, Ejection fraction, Headache, Hypersensitivity, Hypoxia, Lethargy, Lung infiltration, Mental status changes, Metabolic encephalopathy, Mitral valve incompetence, Oedema peripheral, Pleural effusion, Pyrexia, Rash, Respiratory tract congestion, Right ventricular systolic pressure, SARS-CoV-2 test negative, Spinal compression fracture, Staphylococcus test positive, Thrombocytopenia, Tricuspid valve incompetence, Vaccination complication, Vitamin B12 normal, Vitamin D deficiency, Wheezing
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haematopoietic thrombocytopenia (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Osteoporosis/osteopenia (broad), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: COVID19 (Moderna) on 1/26/2021
Other Medications: Coumadin 3 mg PO HS, Vitamin C 1000mg PO daily, Cholecalciferol 125mcg PO daily, Lasix 10 mg PO daily, Protonix 40mg PO HS, Zincate 220(50Zn) one tablet PO daily, Pramoxine (Sarna Sensitive) 1% lotion apply topically 2 times daily after usi
Current Illness: COVID positive 12/30/2020
Preexisting Conditions: CVA (cerebral vascular accident) (CMS/HCC) o Hyperbilirubinemia o Benign prostatic hyperplasia without lower urinary t CVA (cerebral vascular accident) (CMS/HCC) o Hyperbilirubinemia o Benign prostatic hyperplasia without lower urinary tract symptoms o Hemiplegia affecting dominant side, post-stroke (CMS/HCC) o Personal history of PE (pulmonary embolism) o Calculus of proximal right ureter
Allergies: No known allergies
Diagnostic Lab Data: Allergic reaction to COVID vaccine - POA with Skin rash, wheezing, sob, improving, continue on steroid taper, continue on antihistaminics and Pepcid, continue to monitor Allergic reaction to COVID vaccine - POA with Skin rash, wheezing, sob, improving, continue on steroid taper, continue on antihistaminics and Pepcid, continue to monitor o Metabolic encephalopathy POA - multifactorial secondary to the allergic reaction, infection, acute respiratory failure in patient with history of CVA, Improving, CT head negative for acute findings, avoid sedatives and opiates, add Thiamine, normal B12 and folic acid levels o Acute on chronic diastolic CHF -POA SOB with bilateral lower limbs edema, Chest x ray and CT abdomen revealed bilateral small pleural effusion and mild congestion, BNP elevated o Likely ppt by recent steroid use o Echo done revealed EF 63%, severe Bi atrial enlargement, mild MR, AR and TR, RVSP is 23.6 o Continue on Metoprolol but switched to Toprol, switch lasix to IV o Monitor I&O, Monitor vitals, renal functions and electrolytes o Recent covid pneumonia with possible secondary bacterial infection - COVID pneumonia treated in January 2021, currently with persistent bilateral basal infiltrates, repeat COVID pcr is negative, MRSA nasal swab is positive, started on Cefazolin will continue and add Doxycycline PO o Acute Hypoxemic respiratory failure POA secondary to the above, resolving, weaning off O2, continue to monitor O2 sat o Right lower limb cellulitis POA improving, continue on Cefazolin o Thrombocytopenia likely secondary to recent COVID infection, stable and improving, will continue to monitor CBC o Vitamin D deficiency with subacute T11 and T12 superior endplate compression fracture incidental finding in the CT abdomen and pelvis, mild back pain, pain management, avoid opiates o Continue on Vitamin D supplements o H/O CVA with residual dense right hemiplegia and expressive aphasia - continue on PT/OT, continue on aspirin, Warfarin and statin o Metabo
CDC Split Type:

Write-up: 2/24/2021 admitted to hospital with hypoxia, lethargy, rash, altered mental status with HA. Altered mental status with HA, could be due to metabolic encephalopathy and reaction to COVID-19 vaccine. Will check ABG, CT head. Hold gabapentin. Check depakote level. Rash, likely due to allergic reaction to COVID-19 vaccine, hx of reaction to first COVID-19 vaccine with fever needing hospitalization. Start patient on Solu-Medrol and Pepcid. Benadryl p.r.n. Suspected right lower extremity cellulitis, start patient on Ancef. Check MRSA, will rule out right DVT Abn CXR, Bilateral LE edema, CXR seems stable to me, clinically no pneumonia. He does not have "hypoxia" when I was in room, however assisted living reporte 2/24/2021 admitted to hospital with hypoxia, lethargy, rash, altered mental status with HA. Altered mental status with HA, could be due to metabolic encephalopathy and reaction to COVID-19 vaccine. Will check ABG, CT head. Hold gabapentin. Check depakote level. Rash, likely due to allergic reaction to COVID-19 vaccine, hx of reaction to first COVID-19 vaccine with fever needing hospitalization. Start patient on Solu-Medrol and Pepcid. Benadryl p.r.n. Suspected right lower extremity cellulitis, start patient on Ancef. Check MRSA, will rule out right DVT Abn CXR, Bilateral LE edema, CXR seems stable to me, clinically no pneumonia. He does not have "hypoxia" when I was in room, however assisted living reported he was hypoxic this AM, wife said he was wheezy on Sunday could be due to acute on chronic diastolic congestive heart failure, IV Lasix x1. reeval in AM. Echo TTE is pending Abdominal pain and distension, CT abdomen without contrast to rule out other etiology that can cause altered mental status Hx of COVID-19 pneumonia, history of CVA with dense right hemiplegia and expressive aphasia, chronic atrial fibrillation, depression, Will reorder home meds after pharmacist reconciles medication list Generalized weakness, PT/OT DVT prophylaxis warfarin and SCD


VAERS ID: 1058397 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-02-18
Onset:2021-02-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 024M20A / UNK RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Coagulopathy, Discomfort, Dizziness, Erythema, Impaired work ability, Injection site discomfort, Injection site warmth, Insomnia, Limb discomfort, Mobility decreased, Neck pain, Pain
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins A, C, D; Glucosamine (vegetarian), DHEA SR
Current Illness: None
Preexisting Conditions: Osteo Arthritis
Allergies: Allergic to shellfish, iodine, Allegra/Allegra D
Diagnostic Lab Data: None
CDC Split Type:

Write-up: First, extreme upper arm discomfort after nursing student had difficulty stopping the bleeding. Then, within 5 minutes, felt somewhat dizzy as pain radiated across shoulder, up spine and neck, into jaw and right ear. Then, horrible jabbing pain under shoulder blade, followed by a feeling of extreme compression from site of injection to wrist. Checked every 10 minutes or so by nurses for 50 minutes. They said that redness first was up arm then down arm. Once light headedness improved, I left for work (remote teaching from home). By 3:20, I found it hard to focus, the throbbing under my shoulder and compression feeling of my arm increased with diminished feeling in right hand. Usually 97.2 temperature but ran low-grade temp of about 99 degrees for 3 to 4 days. Sleepless night first night with increased pain and discomfort, i.e., no new symptoms but all symptoms increase with difficulty turning neck and head. Area around injection warm for several days, with swelling first 24 hours, resolving over a few days; still dark black and blue today, 8 days later.


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https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=29&SYMPTOMS[]=Cerebral_venous_sinus_thrombosis_%2810083037%29&SYMPTOMS[]=Cerebral_venous_thrombosis_%2810008138%29&SYMPTOMS[]=Coagulopathy_%2810009802%29&SYMPTOMS[]=Deep_vein_thrombosis_%2810051055%29&SYMPTOMS[]=Disseminated_intravascular_coagulation_%2810013442%29&SYMPTOMS[]=Embolism_%2810061169%29&SYMPTOMS[]=Idiopathic_thrombocytopenic_purpura_%2810021245%29&SYMPTOMS[]=Immune_thrombocytopenia_%2810083842%29&SYMPTOMS[]=Immune_thrombocytopenic_purpura_%2810074667%29&SYMPTOMS[]=Ischaemic_stroke_%2810061256%29&SYMPTOMS[]=Myocardial_infarction_%2810028596%29&SYMPTOMS[]=Petechiae_%2810034754%29&SYMPTOMS[]=Pulmonary_embolism_%2810037377%29&SYMPTOMS[]=Purpura_%2810037549%29&SYMPTOMS[]=Thrombocytopenia_%2810043554%29&SYMPTOMS[]=Thrombosis_%2810043607%29&SYMPTOMS[]=Vasculitis_%2810047115%29&VAX=COVID19&VAXMAN=MODERNA


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