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This is VAERS ID 1332836

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1332836
VAERS Form:2
Age:59.0
Sex:Male
Location:Maryland
Vaccinated:2021-04-16
Onset:2021-05-02
Submitted:0000-00-00
Entered:2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 RA / -

Administered by: Unknown      Purchased by: ??
Symptoms: Pneumonitis, Pulmonary thrombosis, SARS-CoV-2 test

Life Threatening? Yes
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)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: LOSARTAN; ATORVASTATIN; OMEPRAZOLE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood cholesterol abnormal; Blood pressure abnormal; Indigestion
Allergies:
Diagnostic Lab Data: Test Date: 20210502; Test Name: covid test; Test Result: Negative ; Comments: Nasal swab
CDC 'Split Type': USPFIZER INC2021541002

Write-up: blood clots in both lungs along with lung inflammation; blood clots in both lungs along with lung inflammation; This is a spontaneous report from a contactable consumer (patient). A 59-year-old male patient received the second dose (reported as dose 1) of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: ER2613), via an unspecified route of administration, administered in the right arm on 16Apr2021 at 08:45 AM as single dose for COVID-19 immunisation. Medical history included cholestoral, blood pressure, indigestion. No known allergies. No covid prior vaccination. Concomitant medications included losartan, avoristatin, omezrapole. The patient previously took the first dose (reported as dose 2) of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: ER2613), via an unspecified route of administration, administered in the left arm on 22Mar2021 at 08:45 AM as single dose for COVID-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 02May2021 at 16:00, patient experienced blood clots in both lungs along with lung inflammation. Events caused a call to the emergency responders and a 2-day hospital stay from 02May2021 to 04May2021. Events resulted in Emergency room/department or urgent care, hospitalization, life threatening illness (immediate risk of death from the event). Lab data included covid test on 02May2021 was negative (Nasal swab). Lots treatment received for the events. The outcome of events was resolved with sequel on unspecified date.

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