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This is VAERS ID 1351591

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1351591
VAERS Form:2
Age:18.0
Sex:Male
Location:Hawaii
Vaccinated:2021-04-06
Onset:2021-04-25
Submitted:0000-00-00
Entered:2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Alveolitis, Angiogram pulmonary abnormal, Blood glucose normal, Chest X-ray abnormal, Dyspnoea, Electrocardiogram abnormal, Fibrin D dimer increased, Haemoptysis, Hepatic steatosis, Hilar lymphadenopathy, Hyperhidrosis, Lung infiltration, Pallor, Pneumonia, Tachycardia, White blood cell count increased, Brain natriuretic peptide increased, Hypertensive urgency, Troponin increased, Electrocardiogram ST-T change, COVID-19, SARS-CoV-2 test negative

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol sulfate, Augmentin 875-125, Flonase, Azithromycin 250mg, L. acidophilus/L. Rhiamnosus, Zyrtec-D, Deltasone 20mg.
Current Illness:
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data: Pertinent labs: WBC: 21.2,glucose: 144; d-dimer: 0.8; troponin: 48; BNP: 2356; COVID = negative EKG interpretation: Rate: 133, NSR, QTc 461 ms, non-specific ST T change, LVH, LAD CXR impression: Central vascular prominence, bronchiolar wall thickening but without overt edema. Cardiac prominence accentuated by portable XR. CTA impression: No PE, normal thoracic aorta. multiple alveolitis/patchy infiltrates particularly in lower lobes peripherally, additional small foci in right upper lobe. Non-specific findings but raise concern for multifocal infection including COVID viral infection. Reactive right hilar adenopathy. Hepatic steatosis.
CDC 'Split Type':

Write-up: Patient received Janssen COVID vaccination on April 6, 2021. Pt had no symptoms initially after vaccination. Pt started coughing up blood and having episodes of dyspnea on April 25, 2021. Pt went to Urgent Care earlier in the day on May 11, 2021 - no medications were given, told he was fine. Pt then went to Medical Center and was found to be pale, diaphoretic, and tachycardic in triage. Pt vitals were temp: 36.6; pulse: 128; respirations: 22; BP: 161/129; SpO2: 97. Hospital medications: carvedilol 6.25mg PO BID, enoxaparin sodium 40mg SQ Q24h, azithromycin 500mg/sodium chloride 250mLs @ 250 mLs/hr IV Q24h, ceftriaxone sodium 2gm/sodium chloride 50mLs @ 100mLs/hr IV Q24h, lisinopril 2.5mg tablet PO QD, metoprolol tartrate 5mg IV Q5MP prn tachycardia. ER disposition: consult for admission Dx: hypertensive urgency, tachycardia, suspected COVID virus infection, bilateral pneumonia

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