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This is VAERS ID 1019345

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1019345
VAERS Form:2
Age:66.0
Sex:Male
Location:Virginia
Vaccinated:2021-01-28
Onset:2021-02-02
Submitted:0000-00-00
Entered:2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 UN / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Full blood count, Platelet count decreased, Immune thrombocytopenia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Doxycycline Lipitor Nexium Lisinopril aspirin
Current Illness: COVID infection-12/28/2020
Preexisting Conditions: Diabetes Hypertension Reflux Rosacea kidney stones
Allergies: NKDA
Diagnostic Lab Data: CBC with platelets of 1000 on 2/2/21; repeat CBC showed platelets of 11,000 on 2/3/21; other CBC findings were normal.
CDC 'Split Type':

Write-up: Pt was found to have ITP-low platelets of 1000 during routine lab work done on 2/2/2021. Pt is asymptomatic--unknown if this is due to recent COVID infection in late Dec/early Jan or due to vaccine. He has responded to steroids and counts are improving.


Changed on 5/7/2021

VAERS ID: 1019345 Before After
VAERS Form:2
Age:66.0
Sex:Male
Location:Virginia
Vaccinated:2021-01-28
Onset:2021-02-02
Submitted:0000-00-00
Entered:2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 UN / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Full blood count, Platelet count decreased, Immune thrombocytopenia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Doxycycline Lipitor Nexium Lisinopril aspirin
Current Illness: COVID infection-12/28/2020
Preexisting Conditions: Diabetes Hypertension Reflux Rosacea kidney stones
Allergies: NKDA NKDA
Diagnostic Lab Data: CBC with platelets of 1000 on 2/2/21; repeat CBC showed platelets of 11,000 on 2/3/21; other CBC findings were normal.
CDC 'Split Type':

Write-up: Pt was found to have ITP-low platelets of 1000 during routine lab work done on 2/2/2021. Pt is asymptomatic--unknown if this is due to recent COVID infection in late Dec/early Jan or due to vaccine. He has responded to steroids and counts are improving.


Changed on 5/21/2021

VAERS ID: 1019345 Before After
VAERS Form:2
Age:66.0
Sex:Male
Location:Virginia
Vaccinated:2021-01-28
Onset:2021-02-02
Submitted:0000-00-00
Entered:2021-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 UN / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Full blood count, Platelet count decreased, Immune thrombocytopenia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Doxycycline Lipitor Nexium Lisinopril aspirin
Current Illness: COVID infection-12/28/2020
Preexisting Conditions: Diabetes Hypertension Reflux Rosacea kidney stones
Allergies: NKDA NKDA
Diagnostic Lab Data: CBC with platelets of 1000 on 2/2/21; repeat CBC showed platelets of 11,000 on 2/3/21; other CBC findings were normal.
CDC 'Split Type':

Write-up: Pt was found to have ITP-low platelets of 1000 during routine lab work done on 2/2/2021. Pt is asymptomatic--unknown if this is due to recent COVID infection in late Dec/early Jan or due to vaccine. He has responded to steroids and counts are improving.

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