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This is VAERS ID 1374431

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1374431
VAERS Form:2
Age:40.0
Sex:Female
Location:Mississippi
Vaccinated:2021-05-03
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Angiogram pulmonary abnormal, Dyspnoea, Pulmonary embolism, Catheter directed thrombolysis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levemir, novolog
Current Illness:
Preexisting Conditions: Diabetes
Allergies: Keflex
Diagnostic Lab Data: CTA chest for PE. EKOS for large burden of pulmonary emboli.
CDC 'Split Type':

Write-up: Patient presented to our facility complaining of shortness of breath. A CTA of the chest revealed bilateral pulmonary emboli.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1374431&WAYBACKHISTORY=ON


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