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This is VAERS ID 1478347

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1478347
VAERS Form:2
Age:82.0
Sex:Female
Location:Michigan
Vaccinated:2021-03-03
Onset:2021-07-01
Submitted:0000-00-00
Entered:2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

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

Life Threatening? No
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)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Beta-carotene, lexapro, cozaar, lopressor, crestor, chemotherapy
Current Illness: Adenocarcinoma of right lung
Preexisting Conditions: history of Hodgkins lymphoma, adenocarcinoma of right lung, bronchiectasis, severe aortic stenosis, HTN, hyperlipidemia, CKD stage 3, depression, immunosuppressed from chemotherapy
Allergies: NKA
Diagnostic Lab Data: Positive COVID PCR on 07/01/21 and 01/13/2021.
CDC 'Split Type':

Write-up: Fully vaccinated patient with additional history of COVID infection in January positive for COVID and admitted for COVID PNA.

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