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This is VAERS ID 1299700

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1299700
VAERS Form:2
Age:57.0
Sex:Male
Location:Tennessee
Vaccinated:2021-04-23
Onset:2021-05-02
Submitted:0000-00-00
Entered:2021-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045B21A / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Asthenia, Pneumonia

Life Threatening? No
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)? No
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Sulfa drugs
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient''s wife stated that on Sunday he was feeling weak most the day. She took his blood oxygen because he is on oxygen for COPD and it was lower than normal. She turned his oxygen up to 5%, then took his blood pressure. His blood pressure was 256/136, so she called the ambulance. When he was brought into the hospital they put him on a ventilator. He is still on a ventilator as of 5/8/2021. The hospital staff said he had double pneumonia and they plan on trying to take him off the ventilator on 5/10/2021.

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