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This is VAERS ID 1361131

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1361131
VAERS Form:2
Age:59.0
Sex:Male
Location:North Carolina
Vaccinated:2021-04-19
Onset:2021-04-30
Submitted:0000-00-00
Entered:2021-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 2 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Asthenia, Atrial fibrillation, Biopsy bone marrow abnormal, Dyspnoea, Epistaxis, Fatigue, Febrile neutropenia, Fluid overload, Full blood count abnormal, Marrow hyperplasia, Megaloblasts increased, Myelodysplastic syndrome, Myocardial infarction, Pancytopenia, Respiratory failure, Retinal haemorrhage, Shock, White blood cell count decreased, Haemodynamic instability, Chemotherapy, Acute kidney injury

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-27
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: 27     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Norvasc, ASA, Lipitor, Coreg, Vitamin B12, Lisinopril, Lofibra, Mag ox, Metformin, MVI, Nitroglycerin, Prilosec, Zoloft, Vitamin A, Dulera,
Current Illness: No acute illnesses
Preexisting Conditions: DM, CAD, HLD, HTN, alcohol use, GERD, gout
Allergies: Norco, Oxycodone
Diagnostic Lab Data: CBC-- $gWBC 2.8 on admission BMBx-- $gHypercellular marrow (90%) involved by myelodysplastic syndrome with excess blasts-2 (15% blasts)
CDC 'Split Type':

Write-up: s/p 2 doses of Covid-19 vaccine. Pt presented for weakness, SOB, fatigue progressive over the past month prior to admission. Found to be pancytopenic with bone marrow biopsy consistent with MDS. He was started on chemo but stay was complicated by neutropenic fevers, epistaxis, retinal hemorrhage, AKI, fluid overload, hypoxic respiratory failure, atrial fibrillation with RVR, and shock. He ultimately had a heart attack while admitted and was transitioned to comfort care after medical interventions could not stabilize hemodynamics.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1361131&WAYBACKHISTORY=ON

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