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This is VAERS ID 1685685

History of Changes from the VAERS Wayback Machine

First Appeared on 9/10/2021

VAERS ID: 1685685
VAERS Form:2
Age:70.0
Sex:Male
Location:Texas
Vaccinated:2021-02-12
Onset:2021-08-16
Submitted:0000-00-00
Entered:2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030M20A / 2 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Condition aggravated, Death, Hypoxia, Pulmonary fibrosis, General physical health deterioration, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-09-03
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: 18     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tivicay 50 mg QD, Descovy 200mg/25 mg QD, Prezcobix 800mg/150 mg QD, Bactrim 800mg/160 mg QD, Pravastatin 10 mg QD, Dulera 200mcg/50 mcg BID, Cyanocobalamin 100 mg QD, Albuterol PRN.
Current Illness:
Preexisting Conditions: HIV Infection, Pulmonary fibrosis
Allergies: NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 1/14/2021 and 2/12/2021. Presented to ED on 8/16/2021 with complaints of worsening hypoxia after a positive COVID test the previous week from an outside facility. Symptom onset was 8/11/2021. Patient has been on 5L NC at baseline for pulmonary fibrosis. Patient treated with dexamethasone, remdesivir, and highflow oxygen. Patient initially improved after 5 days of remdesivir and 10 days of dexamethasone, but hypoxia worsened starting on 8/30/2021. On 9/3/2021 patient rapidly deteriorated, and expired at 1545 on 9/3/2021.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1685685&WAYBACKHISTORY=ON

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