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This is VAERS ID 1685188

History of Changes from the VAERS Wayback Machine

First Appeared on 9/10/2021

VAERS ID: 1685188
VAERS Form:2
Age:79.0
Sex:Male
Location:Texas
Vaccinated:2021-04-02
Onset:2021-08-12
Submitted:0000-00-00
Entered:2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Chills, Cough, Death, Dyspnoea, Fatigue, Nausea, Pain, Pyrexia, Infarction, Decreased appetite, Hypophagia, Endotracheal intubation, Pneumocystis jirovecii pneumonia, COVID-19, SARS-CoV-2 test positive, Positive airway pressure therapy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-08-25
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: 13     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol 90 mcg 2 puffs q4h prn, amlodipine 5mg daily, Eliquis 5mg BID, benzonatate 200mg TID PRN, Tylenol PM 25-500mg nightly prn, Lomotil 2.5-0.025mg 2 tabs QID prn, famotidine 20mg BID, ibuprofen 200mg 2 tabs QID prn
Current Illness:
Preexisting Conditions: HTN, ED, HLD
Allergies: Ciprofloxacin, Sulfa
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccine on 03/11/2021 and 04/02/2021. On 7/12 he began developing symptoms of fatigue, chills, low-grade fevers, body aches, intermittent nausea, poor p.o. intake, poor appetite, some dry cough. He tested COVID positive on 7/16 and continued symptomatic treatment at home. Patient was then admitted 7/24 and discharged on 7/30 with oxygen. Received decadron during this stay. Returned to ER on 8/12 due to worsening shortness of breath. Received vancomycin and cefepime. Started on BiPAP then eventually intubated on 8/17. Patient''s respiratory status continued to worsen. Multifocular infarcts noticed on 8/22. Patient treated for PJP on 8/23. Family planned withdrawal of care on 8/24 after discussion of patient''s poor prognosis. Patient expired on 8/25/21.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1685188&WAYBACKHISTORY=ON

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