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This is VAERS ID 1696412

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/17/2021

VAERS ID: 1696412
VAERS Form:2
Age:52.0
Sex:Male
Location:New Jersey
Vaccinated:2021-02-24
Onset:2021-09-13
Submitted:0000-00-00
Entered:2021-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022M20A / 2 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Asthenia, Cough, Dyspnoea, Fatigue, Nausea, Pain, Pyrexia, Vomiting, Oropharyngeal pain, COVID-19, SARS-CoV-2 test positive, SARS-CoV-2 antibody test

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine 10 mg po daily Rosuvastatin 10 mg po daily Alprazolam 0.5 mg po daily PRN
Current Illness:
Preexisting Conditions: HLP, HTN, anxiety denies any cardiac hx, no hx MI or CAD. Appendectomy Smoking Status Never Smoker.
Allergies: NKDA
Diagnostic Lab Data: Outpatient (+) testing 9/9/21 SARS-CoV-2 Antigen and PCR (+) on 9/13 SARS-CoV-2 IgM 0.06, and IgG 0.01 on 9/14/21
CDC 'Split Type':

Write-up: 53 year old male with hx HTN, HLP, anxiety, presents for evaluation of high fever of 105 today, fatigue, weakness, aches, dry cough, sore throat, mild shortness of breath. He started with symptoms 9 days ago and got worse and went to clinic last thursday 9/9/21 and was told he was positive COVID 19 by PCR. He was concerned due to his high fever so he presented here. He also had intermittant nausea and vomiting, no diarrhea or loss of taste or smell. He has been vaccinated with Moderna back in february 2021.

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