National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1466536

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1466536
VAERS Form:2
Age:83.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-04-07
Onset:2021-07-03
Submitted:0000-00-00
Entered:2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Respiratory failure, COVID-19, SARS-CoV-2 test positive, COVID-19 pneumonia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Acetaminophen, Biotin, bupropion, calcium carb-cholecalciferol, capsaicin 0.025% cream, ferrous sulfate, fexofenadine, fluticasone, gabapentin, lactobacillus rhamnousus, levothyroxine, lidocaine foot cream, multivitamin, nicotine gum, olanz
Current Illness:
Preexisting Conditions: Heart failure with preserved ejection fraction, hx of adenocarcinoma of colon, anemia, B-12 deficiency, depression, hx of DVT, factor V deficiency, fibromyalgia, hyperlipidemia, hypothyroidism, neuropathy/peripheral neuropathy, hx of PE.
Allergies: Sulfa antibiotics
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt received both doses of the Moderna COVID-19 vaccine (on 3/1/2021 and 4/7/2021). She subsequently developed COVID, testing positive via PCR on 7/3/2021 and was admitted to our hospital on 7/3/2021. She was never ill enough to be in the ICU, instead staying in the general med/surg COVID unit until she was discharged on 7/7/2021. Her primary discharge diagnosis was "COVID-19 pneumonia with mild hypoxemic respiratory failure".

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1466536&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166