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This is VAERS ID 1685705

History of Changes from the VAERS Wayback Machine

First Appeared on 9/10/2021

VAERS ID: 1685705
VAERS Form:2
Age:63.0
Sex:Female
Location:Texas
Vaccinated:2021-03-11
Onset:2021-08-25
Submitted:0000-00-00
Entered:2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Bacteraemia, Chills, Cough, Death, Diarrhoea, Fatigue, Haemodialysis, Hypoxia, Myalgia, Pyrexia, Sepsis, Septic shock, Ultrasound kidney normal, Renal impairment, Mechanical ventilation, Endotracheal intubation, Bacterial test, Staphylococcus test positive, Vascular catheterisation, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-08-31
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: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine 5 mg QD, Aspirin 81 mg QD, Atorvastatin 40 mg QD, Calcium Acetate QD, Carvedilol 25 mg BID, Cetririzine 10 mg QD PRN, Clopidogrel 75 mg QD, Ergocalciferol 50,000 units QWeek, Fluticasone nasal BID, Insulin aspart 28 units TID, La
Current Illness:
Preexisting Conditions: Type 2 DM, HTN, hyperlipidemia, Obesity, PVD, CKD, GERD, OSA on CPAP, Hypothyroidism.
Allergies: Lisinopril (Cough), Potassium (Nausea)
Diagnostic Lab Data: Covid Positive Test on 8/25/2021 using Roche LIAT SARS Assay platform using PCR or equivalent nucleic acid amplification technology.
CDC 'Split Type':

Write-up: Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course. Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes. On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic. On 8/31, the patient''s MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21.

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