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From the 7/23/2021 release of VAERS data:

This is VAERS ID 1323749



Case Details

VAERS ID: 1323749 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-23
Onset:2021-05-02
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, COVID-19, Chest X-ray abnormal, Influenza A virus test negative, Influenza B virus test, Legionella test, Metabolic function test, Myalgia, Pain, Pleural effusion, Pyrexia, Respiratory failure, SARS-CoV-2 test positive, Streptococcus test negative, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen 650mg BID albuterol MDI or med neb QID allopurinol 100mg QD clopidogrel 75mg QD fluticasone propionate/salmeterol 500-50mg 1 puff BID furosemide 20mg daily montelukast 10mg daily pravastatin 80mg daily prednisone 30mg QD x3, 2
Current Illness: 4/22/21 Pt was seen by his pulmonologist for a COPD flare and was treated with Augmentin prednisone taper. On 4/29, daughter-in-law called pulmonologist reporting that pt was having fever to 102.7, malaise, anorexia with a known COVID exposure. Pulmonologist urged family to have pt tested so he could be treated with mAB. Pt felt better on 4/30 and declined testing.
Preexisting Conditions: severe COPD (chronic steroids and oxygen) chronic respiratory failure-pt on 6L NC continuously CAD gout HTN hyperlipidemia benign prostatic hypertrophy
Allergies: adenosine amlodipine-atorvastatin ASA codeine iodinated contrast
Diagnostic Lab Data: 5/2/21 NP swab positive for SARS CoV-2, negative influenza A/B urine legionella and strep pneumo antigens negative BMP -normal CXR Suboptimal positioning.;Low lung volumes with bronchovascular crowding.; Strandy bibasilar atelectasis or pneumonia. Small pleural effusions
CDC Split Type:

Write-up: 5/2/21 Pt was hospitalized for 2 days for COVID is a 89 y.o. male patient of , MD with history of steroid and oxygen dependent COPD with chronic hypoxic respiratory failure on 6 L, coronary artery disease, gout, hypertension, hyperlipidemia, BPH, and recent exacerbation of his COPD who presents with fevers, body aches, generalized weakness for 5 days found to have COVID-19 infection Acute on chronic hypoxic respiratory failure Due to COVID-19 infection. On home requirement of 6L NC. Expect he may have a milder course given vaccinated status (though not fully vaccinated until 5/7/21). Update 05/4/2021 Patient stated that he feels that he is back to his baseline Currently on 6 L nasal cannula oxygen His sats was~98 %t rest, with no evidence of respiratory distress Covid-19 Virus Infection Date of onset of symptoms: 4/28/21, Symptoms present on admission: fevers, myalgias, dyspnea, weakness Date of covid positive test: 5/2/21 Vaccination status: vaccinated on 4/1 and 4/23/21 but had exposure on 4/22/21 Imaging: CXR with low lung volumes with bronchovascular crowing and strandy bibasilar pneumonia with small pleural effusions Oxygen requirements on admission: 6L Current oxygen requirements: 6L Medical therapy: Received x3 doses of remdesivir while in the hospital, will complete total 10 days of dexamethasone treatment Consultants following: pulmonary Anticipated special isolation end date: 5/8/21 Generalized weakness Due to above issues -PT/OT consults COPD with chronic hypoxic respiratory failure GOLD grade 3, group D, follows with Dr. as an outpatient and recently completed a course of prednisone taper and augmentin on 5/1/21.Chronically declines PFTs in the past. He is on chronic prednisone at 5mg daily and uses 4-6L NC continuously at home. Pneumovax 2010, prevnar 2015. -Continue home spiriva, symbicort, singulair, and albuterol MDI 4x daily -ST consulted, recommended chopped/NDD 3, thin liquids -Discharge home to complete total 10 days of dexamethasone -Can restart his home prednisone afterwards


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