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This is VAERS ID 1032163

History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 1032163
VAERS Form:2
Age:51.0
Sex:Female
Location:Georgia
Vaccinated:2021-01-16
Onset:2021-02-01
Submitted:0000-00-00
Entered:2021-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaemia, Asthenia, Computerised tomogram abnormal, Death, Disseminated intravascular coagulation, Haemoglobin decreased, Hepatic function abnormal, Metastases to liver, Oedema peripheral, Pain, Petechiae, Platelet count decreased, Purpura, Vaginal haemorrhage, White blood cell count increased, Transfusion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol 2.5 mg via nebulizer q4h PRN for SOB, alectinib 600 mg PO BID, apixaban 5 mg BID, bumetanide 2 mg q other day, calcium-vitamin D 500-200 mg BID, famoitidine 20 mg daily, ferrous sulfate 325 mg BID, methadone 5 mg q6h, midodrine 10
Current Illness: Progressive liver metastases seen on CT 1/26/21 in the setting of metastatic non-small cell lung cancer (diagnosed 9/2020)
Preexisting Conditions: HPV, iron deficiency anemia, abnormal uterine bleeding, history of COVID-19 hospitalization ( 8/2020), migraines, nonalcoholic fatty liver disease, GERD, pre-diabetes
Allergies: iodinated contrast (rash, itching)
Diagnostic Lab Data: On admission (2/6/21): WBC: 37.89k Hgb 5.7 g/dL Plt: 75k On 2/11: WBC 53k Hgb 8.1 Plt: 27k
CDC 'Split Type':

Write-up: Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura with pain and weakness. Palliative care consulted. Patient passed away on 2/11.


Changed on 5/7/2021

VAERS ID: 1032163 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Georgia
Vaccinated:2021-01-16
Onset:2021-02-01
Submitted:0000-00-00
Entered:2021-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaemia, Asthenia, Computerised tomogram abnormal, Death, Disseminated intravascular coagulation, Haemoglobin decreased, Hepatic function abnormal, Metastases to liver, Oedema peripheral, Pain, Petechiae, Platelet count decreased, Purpura, Vaginal haemorrhage, White blood cell count increased, Transfusion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol 2.5 mg via nebulizer q4h PRN for SOB, alectinib 600 mg PO BID, apixaban 5 mg BID, bumetanide 2 mg q other day, calcium-vitamin D 500-200 mg BID, famoitidine 20 mg daily, ferrous sulfate 325 mg BID, methadone 5 mg q6h, midodrine 10
Current Illness: Progressive liver metastases seen on CT 1/26/21 in the setting of metastatic non-small cell lung cancer (diagnosed 9/2020)
Preexisting Conditions: HPV, iron deficiency anemia, abnormal uterine bleeding, history of COVID-19 hospitalization ( 8/2020), migraines, nonalcoholic fatty liver disease, GERD, pre-diabetes
Allergies: iodinated contrast (rash, itching) itching)
Diagnostic Lab Data: On admission (2/6/21): WBC: 37.89k Hgb 5.7 g/dL Plt: 75k On 2/11: WBC 53k Hgb 8.1 Plt: 27k
CDC 'Split Type':

Write-up: Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura with pain and weakness. Palliative care consulted. Patient passed away on 2/11.


Changed on 5/14/2021

VAERS ID: 1032163 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Georgia
Vaccinated:2021-01-16
Onset:2021-02-01
Submitted:0000-00-00
Entered:2021-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaemia, Asthenia, Computerised tomogram abnormal, Death, Disseminated intravascular coagulation, Haemoglobin decreased, Hepatic function abnormal, Metastases to liver, Oedema peripheral, Pain, Petechiae, Platelet count decreased, Purpura, Vaginal haemorrhage, White blood cell count increased, Transfusion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol 2.5 mg via nebulizer q4h PRN for SOB, alectinib 600 mg PO BID, apixaban 5 mg BID, bumetanide 2 mg q other day, calcium-vitamin D 500-200 mg BID, famoitidine 20 mg daily, ferrous sulfate 325 mg BID, methadone 5 mg q6h, midodrine 10
Current Illness: Progressive liver metastases seen on CT 1/26/21 in the setting of metastatic non-small cell lung cancer (diagnosed 9/2020)
Preexisting Conditions: HPV, iron deficiency anemia, abnormal uterine bleeding, history of COVID-19 hospitalization ( 8/2020), migraines, nonalcoholic fatty liver disease, GERD, pre-diabetes
Allergies: iodinated contrast (rash, itching) itching)
Diagnostic Lab Data: On admission (2/6/21): WBC: 37.89k Hgb 5.7 g/dL Plt: 75k On 2/11: WBC 53k Hgb 8.1 Plt: 27k
CDC 'Split Type':

Write-up: Patient received dose #1 of COVID-19 vaccine on 1/16/21. Within 3 days, she developed petechiae up to ankles, later rising up to her knees. Pt admitted to hospital on 2/6/21 for symptomatic anemia 2/2 vaginal bleeding. Patient received 4 units FFP, 4 units PRBC, 1 unit cryoprecipitate, and vitamin K 5 mg IV. Also started on medroxyprogesterone 20 mg PO TID. Alectinib d/ced due to worsening liver function. Evalauted by OB/GYN and Hematology. Diagnosed with DIC. Patient with worsening bilateral lower extremity edema and purpura with pain and weakness. Palliative care consulted. Patient passed away on 2/11.

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