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From the 1/14/2022 release of VAERS data:

This is VAERS ID 1040955

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Case Details

VAERS ID: 1040955 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-02-05
Onset:2021-02-13
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-02-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood fibrinogen, Blood smear test normal, Ecchymosis, Fibrin D dimer normal, Haematochezia, Haemoglobin normal, Immunoglobulin therapy, Petechiae, Platelet count decreased, Platelet transfusion, Rash, Rectal haemorrhage, White blood cell count normal
SMQs:, Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Hypersensitivity (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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin 81mg Atorvastatin 20mg Caltrate 600+D 600mg calcium - 800 unit - 50mg tablet Levothyroxine 100mcg Zyrtec 10mg Oxbutynin 5mg Tolterodine 2mg
Current Illness: none
Preexisting Conditions: Hyperlipidemia, overactive bladder, hypothyroidism, hemorrhoids
Allergies: grass pollen
Diagnostic Lab Data: Normal WBC and HbG. No schistocytes on blood smear. Normal Fribrinogen, normal D-dimer.
CDC Split Type:

Write-up: Patient presented with hematochezia and bright red blood per rectum. Platelets were severely down to 1k. This was about 2 weeks after receiving the moderna COVID-19 vaccine first dose. Patient also with extensive ecchymosis on upper extremities and petechial rash on legs. Concern for ITP related to the drug. Patient received IVIg, Platelet transfussion, and steroids. Platelets slowly increasing, patient received NPLATE. The patient remains hospitalized with platelets up trending from 1--- $g4--- $g6--- $g5--- $g9--- $g11.


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