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This is VAERS ID 1047351

History of Changes from the VAERS Wayback Machine

First Appeared on 2/26/2021

VAERS ID: 1047351
VAERS Form:2
Age:55.0
Sex:Male
Location:Oklahoma
Vaccinated:2021-01-29
Onset:2021-02-17
Submitted:0000-00-00
Entered:2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Asthenia, Blood creatinine increased, Diarrhoea, Dyspnoea, Fibrin D dimer increased, Gastritis, Hypoxia, Lung infiltration, Serum ferritin increased, Skin ulcer, Troponin increased, Limb injury, Decreased appetite, Procalcitonin increased, Liver function test increased, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-17
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: 2/10/2021: Metoclopromide, Famotidine, 2/13/2021: Remdesivir, Lovenox, Azithromysin, Meropenem
Current Illness: Covid-19 positive on 2/2/2021
Preexisting Conditions: Diabetes type 2, Hypertension
Allergies: Morphine, Zosyn, Piperacillin
Diagnostic Lab Data: Sars PCR 2/2/21
CDC 'Split Type':

Write-up: Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite. Diagnosed: 1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city.


Changed on 5/7/2021

VAERS ID: 1047351 Before After
VAERS Form:2
Age:55.0
Sex:Male
Location:Oklahoma
Vaccinated:2021-01-29
Onset:2021-02-17
Submitted:0000-00-00
Entered:2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Asthenia, Blood creatinine increased, Diarrhoea, Dyspnoea, Fibrin D dimer increased, Gastritis, Hypoxia, Lung infiltration, Serum ferritin increased, Skin ulcer, Troponin increased, Limb injury, Decreased appetite, Procalcitonin increased, Liver function test increased, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-17
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: 2/10/2021: Metoclopromide, Famotidine, 2/13/2021: Remdesivir, Lovenox, Azithromysin, Meropenem
Current Illness: Covid-19 positive on 2/2/2021
Preexisting Conditions: Diabetes type 2, Hypertension
Allergies: Morphine, Zosyn, Piperacillin Piperacillin
Diagnostic Lab Data: Sars PCR 2/2/21
CDC 'Split Type':

Write-up: Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite. Diagnosed: 1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city.


Changed on 5/14/2021

VAERS ID: 1047351 Before After
VAERS Form:2
Age:55.0
Sex:Male
Location:Oklahoma
Vaccinated:2021-01-29
Onset:2021-02-17
Submitted:0000-00-00
Entered:2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Asthenia, Blood creatinine increased, Diarrhoea, Dyspnoea, Fibrin D dimer increased, Gastritis, Hypoxia, Lung infiltration, Serum ferritin increased, Skin ulcer, Troponin increased, Limb injury, Decreased appetite, Procalcitonin increased, Liver function test increased, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-17
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: 2/10/2021: Metoclopromide, Famotidine, 2/13/2021: Remdesivir, Lovenox, Azithromysin, Meropenem
Current Illness: Covid-19 positive on 2/2/2021
Preexisting Conditions: Diabetes type 2, Hypertension
Allergies: Morphine, Zosyn, Piperacillin Piperacillin
Diagnostic Lab Data: Sars PCR 2/2/21
CDC 'Split Type':

Write-up: Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite. Diagnosed: 1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city.

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