National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1662469

History of Changes from the VAERS Wayback Machine

First Appeared on 9/3/2021

VAERS ID: 1662469
VAERS Form:2
Age:67.0
Sex:Female
Location:Unknown
Vaccinated:2021-04-08
Onset:2021-04-09
Submitted:0000-00-00
Entered:2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 017B21A / 2 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Bradycardia, Cardiac pacemaker insertion, Catheterisation cardiac, Death, Tracheostomy, Unresponsive to stimuli, Ventricular tachycardia, Vomiting, Gastrostomy, Physical deconditioning, Endotracheal intubation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-19
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: 39     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patinet presented to the emergency department for evaluation after being found unresponsive at home prior to arrival. Unable to obtain history from patient due to intubated status. She was found down on the floor by a neighbor. It is unknown how she got on the floor or for how long she was down. She had an episode of emesis upon arrival of EMS, and was found to be bradycardic. She was given 3 mg Atropine en route. She denied any falls or injuries, chest pain, or SOB prior to intubation. She also denied any drug or alcohol use in the ED. She had received her second COVID vaccine on 4/8/2021, admitted to hospital on 4/10/2021. She was intubated and had placement of temporary pacemaker on 4/10/2021. Patient had a tracheostomy placed on 04/22/2021, a permanent pacemaker placed on 04/28/2021, & a PEG tube placed on 04/29/2021. She had episodes of ventricular tachycardia and underwent a cardiac cath on 5/11/21. With deconditioning and multiple comorbidities-family decided to switch her to comfort measures and patient expired on 5/19/2021.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1662469&WAYBACKHISTORY=ON

Government Disclaimer on use of this data


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