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This is VAERS ID 1032165

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 1032165
VAERS Form:2
Age:36.0
Sex:Female
Location:Nevada
Vaccinated:2021-02-06
Onset:2021-02-09
Submitted:0000-00-00
Entered:2021-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Body temperature increased, Chills, Echocardiogram, Electrocardiogram ambulatory, Flank pain, Pain, Painful respiration, Pleural effusion, Pulmonary embolism, Pulmonary infarction, Ultrasound Doppler, Computerised tomogram thorax, Laboratory test, SARS-CoV-2 test negative

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Escitalopram, Prenate Mini, Loratadine, Vitamin D3, Fluticasone nasal spray
Current Illness: None
Preexisting Conditions: Allergic rhinitis, Asthma, Depression, Anxiety, Lactation, Anti-thrombin III Deficiency
Allergies: Penicillin
Diagnostic Lab Data: CT chest Bilateral lower extremity doppler ECHO Holter monitor Labs COVID negative
CDC 'Split Type':

Write-up: 2/6 I had the 2nd Moderna vaccine. On 2/7-2/8 I had body aches, chills, and 99.4F temp. On 2/9 those symptoms subsided, but I started to get right-sided flank pain with pain on inhalation. I took acetaminophen and ibuprofen around the clock, used a heating pad on 2/9 and 2/10, but pain progressed. Mid-day on 2/10 the pain was so severe, I went to urgent care. They said it was gastritis and released me. I went back 2 hours later and saw a different doctor. He diagnosed me with a pulmonary embolism, pulmonary infarction, and pleural effusion. I was sent by ambulance to the hospital and admitted. I was treated for pain and started on Eliquis. I was discharged the evening of 2/12. The morning of 2/13, I woke up with 100.6 F Temp and 85% O2 at. I went to urgent care again, they thought I had pneumonia and referred me to the hospital. I was admitted to a different hospital on 2/12 and continue to antibiotic s and a heparin drip


Changed on 5/7/2021

VAERS ID: 1032165 Before After
VAERS Form:2
Age:36.0
Sex:Female
Location:Nevada
Vaccinated:2021-02-06
Onset:2021-02-09
Submitted:0000-00-00
Entered:2021-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Body temperature increased, Chills, Echocardiogram, Electrocardiogram ambulatory, Flank pain, Pain, Painful respiration, Pleural effusion, Pulmonary embolism, Pulmonary infarction, Ultrasound Doppler, Computerised tomogram thorax, Laboratory test, SARS-CoV-2 test negative

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Escitalopram, Prenate Mini, Loratadine, Vitamin D3, Fluticasone nasal spray
Current Illness: None
Preexisting Conditions: Allergic rhinitis, Asthma, Depression, Anxiety, Lactation, Anti-thrombin III Deficiency
Allergies: Penicillin Penicillin
Diagnostic Lab Data: CT chest Bilateral lower extremity doppler ECHO Holter monitor Labs COVID negative
CDC 'Split Type':

Write-up: 2/6 I had the 2nd Moderna vaccine. On 2/7-2/8 I had body aches, chills, and 99.4F temp. On 2/9 those symptoms subsided, but I started to get right-sided flank pain with pain on inhalation. I took acetaminophen and ibuprofen around the clock, used a heating pad on 2/9 and 2/10, but pain progressed. Mid-day on 2/10 the pain was so severe, I went to urgent care. They said it was gastritis and released me. I went back 2 hours later and saw a different doctor. He diagnosed me with a pulmonary embolism, pulmonary infarction, and pleural effusion. I was sent by ambulance to the hospital and admitted. I was treated for pain and started on Eliquis. I was discharged the evening of 2/12. The morning of 2/13, I woke up with 100.6 F Temp and 85% O2 at. I went to urgent care again, they thought I had pneumonia and referred me to the hospital. I was admitted to a different hospital on 2/12 and continue to antibiotic s and a heparin drip


Changed on 5/21/2021

VAERS ID: 1032165 Before After
VAERS Form:2
Age:36.0
Sex:Female
Location:Nevada
Vaccinated:2021-02-06
Onset:2021-02-09
Submitted:0000-00-00
Entered:2021-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Body temperature increased, Chills, Echocardiogram, Electrocardiogram ambulatory, Flank pain, Pain, Painful respiration, Pleural effusion, Pulmonary embolism, Pulmonary infarction, Ultrasound Doppler, Computerised tomogram thorax, Laboratory test, SARS-CoV-2 test negative

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Escitalopram, Prenate Mini, Loratadine, Vitamin D3, Fluticasone nasal spray
Current Illness: None
Preexisting Conditions: Allergic rhinitis, Asthma, Depression, Anxiety, Lactation, Anti-thrombin III Deficiency
Allergies: Penicillin Penicillin
Diagnostic Lab Data: CT chest Bilateral lower extremity doppler ECHO Holter monitor Labs COVID negative
CDC 'Split Type':

Write-up: 2/6 I had the 2nd Moderna vaccine. On 2/7-2/8 I had body aches, chills, and 99.4F temp. On 2/9 those symptoms subsided, but I started to get right-sided flank pain with pain on inhalation. I took acetaminophen and ibuprofen around the clock, used a heating pad on 2/9 and 2/10, but pain progressed. Mid-day on 2/10 the pain was so severe, I went to urgent care. They said it was gastritis and released me. I went back 2 hours later and saw a different doctor. He diagnosed me with a pulmonary embolism, pulmonary infarction, and pleural effusion. I was sent by ambulance to the hospital and admitted. I was treated for pain and started on Eliquis. I was discharged the evening of 2/12. The morning of 2/13, I woke up with 100.6 F Temp and 85% O2 at. I went to urgent care again, they thought I had pneumonia and referred me to the hospital. I was admitted to a different hospital on 2/12 and continue to antibiotic s and a heparin drip

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