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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH||EW0175 / 1||- / IM|
Administered by: Private Purchased by: ??
Symptoms: Blood creatinine increased, Cardiac arrest
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Other Medications: Apixaban, Atorvastatin, Calcium gluconate, Meropenem, Vancomycin, Epogen, Benadryl
Current Illness: Pulmonary HTN, CKD (HD 3x a week), cirrhosis (paracentesis 2 days prior to hospital admission), patient developed fever of 103 & chest tightness while at dialysis,, CHF, pneumonia
Preexisting Conditions: aortic valve replacement 2018, aortic tricuspid regurgitation, pancreatitis, home oxygen use 4L/hr, crack use 2018, CHF, BMI 31.3kg
Allergies: Spironolactone, Zofran, Solumedrol
Diagnostic Lab Data: Patient had anemia of chronic disease/CDK, high serum creatinine (HD)
CDC 'Split Type':
Write-up: received the vaccine as an inpatient in our hospital on 5/21/21. Patient went into cardiac arrest on 5/22/21 at approximately 9:00am
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