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This is VAERS ID 1323625

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1323625
VAERS Form:2
Age:65.0
Sex:Male
Location:Kentucky
Vaccinated:2021-05-04
Onset:2021-05-04
Submitted:0000-00-00
Entered:2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 UN / IM

Administered by: Other      Purchased by: ??
Symptoms: Dyspnoea, Muscle spasms, Pain in extremity, Panic attack, Pulmonary embolism, Rash, Muscle tightness, Anticoagulant therapy

Life Threatening? No
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)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: metformin, pantoprazole, fluoxetine, aspirin, metoprolol tartrate, simvastatin, pramipexole, glimepiride, meloxicam, isosorbide mononitrate, carbidopa/levodopa
Current Illness:
Preexisting Conditions: Diabetes, hypercholesterolemia, congenital heart valve defect
Allergies: Gapabentin ("stroke episode" ~ 2019)
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient received vaccine on tuesday 5/4. Patient developed a rash surrounding both ankles. Patient and wife dismissed this as possible side effect of vaccine. The patient had difficulty breathing and dismissed it as a panic attack on 5/10. Symptoms continued for several days, went to walk-in clinic on Wednesday 5/12 for tests and inconclusive. Thursday 5/13 the patient continued to experience these symptoms and elevated pain, tightness and cramping in legs and went to the ER where he was diagnosed with bilateral pulmonary emboli. Patient was admitted for 2 days and treated for clots. Upon discharge the patient was instructed to discontiue meloxicam, carbidopa/levodopa and started on eliquis for 6 months. After 6 months the patient will follow-up with a hemotologist.

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