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This is VAERS ID 1274139

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1274139
VAERS Form:2
Age:61.0
Sex:Female
Location:Maryland
Vaccinated:2021-01-19
Onset:2021-01-20
Submitted:0000-00-00
Entered:2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaemia, Cardiac failure, Cardiac pacemaker insertion, Cardiogenic shock, Cough, Fatigue, Hyperhidrosis, Hypotension, Myocarditis, Oral candidiasis, Urinary tract infection, Dialysis, Acute kidney injury

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations:
Other Medications: metoprolol, Trulicity, metformin, losartan, Protonix, Zetia, Tylenol, aspirin
Current Illness: COVID + on 01/05/2021
Preexisting Conditions: HTN, DM, hypercholesterolemia, SVT
Allergies: penicillin, Daypro, Augmentin, codeine, morphine, Reglan, statins, Mobic, pineapple, paper tape
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1/20/2021 - pt experiencing marked fatigue 01/23/2021 - pt went to ED with fatigue, sweats, cough, and low BP. Admitted with diagnoses of cardiogenic shock, myocarditis, acute renal failure, heart failure, anemia, UTI, oral thrush. Treated with IV fluids, dialysis, temporary pacemaker. 02/06/2021 - discharged to rehab facility 02/17/2021 - discharged home

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