National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/19/2021 release of VAERS data:

This is VAERS ID 1768579

Government Disclaimer on use of this data



Case Details

VAERS ID: 1768579 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-28
Onset:2021-10-04
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Aspartate aminotransferase increased, Atrial fibrillation, Blood albumin decreased, Blood potassium normal, Blood sodium decreased, C-reactive protein increased, COVID-19, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Cough, Dizziness, Dyspnoea, Fibrin D dimer, Full blood count, Haemoglobin decreased, Intensive care, Lung opacity, Lymphocyte count decreased, Metabolic function test, N-terminal prohormone brain natriuretic peptide increased, Nausea, Platelet count decreased, Procalcitonin, Pyrexia, Red blood cell sedimentation rate increased, SARS-CoV-2 test positive, Troponin increased, Vomiting, Wheezing
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin, clopidogrel, Advair, lisinopril, metoprolol succinate, simvastatin
Current Illness:
Preexisting Conditions: COPD, tobacco abuse, severe obesity (class 3), obstructive sleep apnea
Allergies: NKA
Diagnostic Lab Data: 10/7/21 COVID-19, rapid: positive CBC: platelets 133; HBG 13.4; lymphocytes 15 Sed rate: 62 Chest X-ray: right lateral mid-field opacity; bibasilar opacities d-dimer: 1.37 Pro-BNP: 1137 CMP: sodium 130; potassium 3.6; AST 49; albumin 3.4 CRP: 129.7 Procalcitonin: 0.14 troponin (high sensitivity): 36 Chest CT: bilateral opacities
CDC Split Type:

Write-up: On approximately 10/4/21 the patient began experiencing nausea and vomiting, cough, and shortness of breath. On 10/7/21 the patient began feeling associated dizziness and lightheadedness with his shortness of breath. Per EMS report, the patient''s O2 sats were in the high 80s with bilateral wheezing when they arrived. The patient received a Duoneb treatment in the field. Patient was found to have A-fib with RVR in ED (HR in the 150s on initial presentation) and patient has no known history of A-fib. Patient was febrile to 103 F. Patient was started on anticoagulation, fluids, and a diltiazem drip. Patient is requiring high flow O2. Patient is positive for COVID-19 by rapid test. The patient will be admitted to ICU.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1768579


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