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This is VAERS ID 1768926

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First Appeared on 10/8/2021

VAERS ID: 1768926
VAERS Form:2
Age:45.0
Sex:Male
Location:Unknown
Vaccinated:2021-10-05
Onset:2021-10-05
Submitted:0000-00-00
Entered:2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3592 / UNK - / IM

Administered by: Military      Purchased by: ??
Symptoms: Alanine aminotransferase increased, Angina pectoris, Arteriogram carotid normal, Aspartate aminotransferase normal, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood cholesterol normal, Blood creatine phosphokinase normal, Blood glucose normal, Blood magnesium normal, Blood pressure increased, Blood thyroid stimulating hormone, Blood thyroid stimulating hormone normal, Blood triglycerides decreased, Chest pain, Chest X-ray abnormal, Disturbance in attention, Dizziness, Electrocardiogram normal, Full blood count normal, Glucose urine absent, Blood urine absent, Headache, Hemiparesis, High density lipoprotein increased, Hypoaesthesia, Interstitial lung disease, Lipase normal, Low density lipoprotein normal, Mean cell volume normal, Pain, Pain in extremity, pH urine normal, Protein total normal, Protein urine absent, Sensory loss, Specific gravity urine normal, Tinnitus, Tremor, Urine abnormality, Very low density lipoprotein decreased, White blood cells urine negative, Arachnoid cyst, Blood phosphorus decreased, Urinary sediment present, Urine leukocyte esterase, Drug screen negative, Basophil percentage increased, Eosinophil percentage increased, Urodynamics measurement, Cardiac flutter, Angiogram cerebral normal, Bilirubin urine, Red cell distribution width normal, Laboratory test normal, Mean platelet volume normal, Neurological examination abnormal, Urine ketone body present, Neutrophil percentage, Monocyte percentage, Lymphocyte percentage, Hepatic enzyme increased, Nitrite urine absent, Neurological symptom, Inflammation, Urine analysis normal, Scan with contrast normal, Metabolic function test, Metabolic function test normal, Paranasal cyst, Amphetamines negative, Barbiturates negative, Opiates negative, Mastoid effusion, Urobilinogen urine decreased, Slow speech, Troponin normal, Computerised tomogram head abnormal, Troponin I normal, Mucosal hypertrophy, Mucosal disorder, Magnetic resonance imaging head abnormal, Magnetic resonance imaging head normal

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: hypertension
Allergies: none
Diagnostic Lab Data: Labs: -=---------------------------< 07 Oct 2021 $g--------------------------=- (time: 1025) Triacylglycerol Lipase = 27 Phosphate = 2.9 Troponin I Cardiac = <0.01 CMP 144 : 107 : 11 AG {?} Ca 9.1 AST 33 -------+-------+-------< 109 Prot 7.0 ALT 58 4.1 : 28 : 1.0 Alb 4.1 AP 56 Bili 0.4 LIPID PANEL Triglyceride = 31 LDL Cholesterol = 54 VLDL Cholesterol = 6 Cholesterol = 118 Cholesterol/HDL Cholesterol = 2.0 HDL Cholesterol = 58 CBC %N 65.5 / 14.6 / MCV 85.6 %E 2.2 5.50 $g----< 242 RDW 13.2 %B 0.9 / 42.1 / MPV 9.4 %M {?} %L 23.6 (time: 0944) Glucose = 114 -=---------------------------< 06 Oct 2021 $g--------------------------=- (time: 0150) DRUG SCREEN URINE Methylenedioxymethamphetamine = NONE DETECTED Oxycodone = NONE DETECTED Propoxyphene = NONE DETECTED Amphetamines = NONE DETECTED Barbiturates = NONE DETECTED Benzodiazepines = NONE DETECTED Cocaine = NONE DETECTED Opiates = NONE DETECTED Phencyclidine = NONE DETECTED Cannabinoids = NONE DETECTED Methadone Confirm = NONE DETECTED URINALYSIS Color = Yellow Clarity = Clear Specific Gravity = 1.024 Protein = Negative Glucose = NEGATIVE Ketones = 5 mg/dl Bilirubin = NEGATIVE Blood = Negative Nitrite = NEGATIVE Urobilinogen = Normal Leukocyte Esterase = NEGATIVE Epithelial Cells Squamous = <1/HPF Mucus = FEW pH = 6.0 WBC = <1 -=---------------------------< 05 Oct 2021 $g--------------------------=- (time: 2258) Glucose = 105 (time: 2350) Magnesium = 2.2 Phosphate = 4.2 Troponin I Cardiac = <0.01 Thyrotropin = 4.01 Creatine Kinase = 149 CMP 143 : 108 : 15 AG {?} Ca 9.1 AST 35 -------+-------+-------< 105 Prot 6.6 ALT 63 4.2 : 28 : 1.1 Alb 4.1 AP 44 Bili 0.4 CBC %N 65.0 / 14.0 / MCV 86.3 %E 2.6 7.29 $g----< 230 RDW 13.4 %B 0.7 / 41.0 / MPV 9.7 %M {?} %L 24.3 Rads: **********MRI, BRAIN (W/O CONTRAST)********** Status: Complete Procedure: MRI, BRAIN (W/O CONTRAST) Order Date: 07-Oct-2021 12:49:00 Order Comment: ED-16 Reason for Order: L face tingling, Hx L arm tingling Exam Date/Time: 07-Oct-2021 13:19:00 Transcription Date/Time: 07-Oct-2021 13:57:00 Status: COMPLETE Result Code: SEE RADIOLOGIST''S REPORT Approved Date/Time: 07-Oct-2021 13:52:00 Report Text: Brain MRI without gadolinium History: Left face tingling in left arm tingling. Technique: MRI of the brain was performed utilizing the following sequences: Sagittal 3-D T1 with MPRs, axial DWI, axial T2 FLAIR, axial T1, axial SWI, sagittal 3-D T2 FLAIR and axial T2 FINDINGS: Acute: No hemorrhage, herniation, or hydrocephalus. No evidence of recent infarct. Brain: Incidental note of mega cisterna magna or arachnoid cyst in the posterior fossa. No evidence of vermian hypoplasia. Otherwise, brain parenchyma is within normal limits in signal and volume for age. Vessels: No abnormal intravascular signal to suggest thrombosis. Bones: No suspicious lesion in the calvarium or skull base. Other: Diffuse paranasal sinus mucosal disease. IMPRESSION: No acute intracranial findings. **********CT, HEAD/BRAIN ANGIOGRAM (W/CONTRAST) (PG)********** Status: Complete Procedure: CT, HEAD/BRAIN ANGIOGRAM (W/CONTRAST) (PG) Order Date: 05-Oct-2021 23:30:00 Order Comment: ED-22 Reason for Order: ABNORMAL PARAESTHESIAS NOT FITTING IN TYPICAL ANATOMIC DISTRUBUTION Exam Date/Time: 06-Oct-2021 00:45:00 Transcription Date/Time: 06-Oct-2021 01:25:00 Status: COMPLETE Result Code: SEE RADIOLOGIST''S REPORT Approved Date/Time: 06-Oct-2021 01:25:00 Report Text: APPROVED DATE/TIME: 06 Oct 2021@0024 REASON: ABNORMAL PARAESTHESIAS NOT FITTING IN TYPICAL ANATOMIC DISTRUBUTION CONTRAST - TYPE: ISOVUE 370 VOLUME: 60ml STUDY CODE: CODE 1000 NO ALERT REQUIRED PROCEDURE: CT, HEAD/BRAIN ANGIOGRAM (W/CONT CT angiogram head and neck. Axial data was acquired from the aortic arch to the vertex during dynamic arterial phase contrast administration. Multiplanar reformatted images were obtained on an independent 3-D workstation. Calculation of stenoses was obtain utilizing NASCET criteria. Dose reduction techniques were utilized. Priors: CT head of same date. Findings: Aortic arch is normal in caliber. The origin of the innominate artery, left common carotid artery and left subclavian arteries are patent. Right common and right subclavian artery origins are patent. The bilateral vertebral artery origins are patent. Left carotid: There is no atherosclerotic disease or stenosis. Right carotid: There is no atherosclerotic disease or stenosis. Vertebral arteries: There is no evidence of focal stenosis or occlusion. There is no evidence of dissection. Anterior circulation: The internal carotid arteries are present at the skull base. The supraclinoid internal carotid arteries, anterior and middle cerebral arteries are patent without evidence of focal stenosis or occlusion. Posterior circulation: The distal vertebral arteries, basilar artery and proximal posterior cerebral arteries and superior cerebellar arteries are patent. There is no evidence of focal stenosis or occlusion. There is no evidence of aneurysm or vascular malformation. Dural venous sinuses are patent. Impression: No evidence of significant stenosis, occlusion or vascular malformation. Attention Patients / Service-members: If you have questions or concerns about the results in this report, Please contact your ordering provider or primary care team. **********CT, NECK ANGIOGRAM (W/CONTRAST) (PG)********** Status: Complete Procedure: CT, NECK ANGIOGRAM (W/CONTRAST) (PG) Order Date: 05-Oct-2021 23:31:00 Order Comment: ED-22 Reason for Order: Abnormal paresthesias not fitting in typical anatomic distrubution Exam Date/Time: 06-Oct-2021 00:45:00 Transcription Date/Time: 06-Oct-2021 01:26:00 Status: COMPLETE Result Code: SEE RADIOLOGIST''S REPORT Approved Date/Time: 06-Oct-2021 01:26:00 Report Text: APPROVED DATE/TIME: 06 Oct 2021@0024 REASON: Abnormal paresthesias not fitting in typical anatomic distrubution CONTRAST - TYPE: ISOVUE 370 VOLUME: 60ml STUDY CODE: CODE 1000 NO ALERT REQUIRED PROCEDURE: CT, NECK ANGIOGRAM (W/CONTRAST) CT angiogram head and neck. Axial data was acquired from the aortic arch to the vertex during dynamic arterial phase contrast administration. Multiplanar reformatted images were obtained on an independent 3-D workstation. Calculation of stenoses was obtain utilizing NASCET criteria. Dose reduction techniques were utilized. Priors: CT head of same date. Findings: Aortic arch is normal in caliber. The origin of the innominate artery, left common carotid artery and left subclavian arteries are patent. Right common and right subclavian artery origins are patent. The bilateral vertebral artery origins are patent. Left carotid: There is no atherosclerotic disease or stenosis. Right carotid: There is no atherosclerotic disease or stenosis. Vertebral arteries: There is no evidence of focal stenosis or occlusion. There is no evidence of dissection. Anterior circulation: The internal carotid arteries are present at the skull base. The supraclinoid internal carotid arteries, anterior and middle cerebral arteries are patent without evidence of focal stenosis or occlusion. Posterior circulation: The distal vertebral arteries, basilar artery and proximal posterior cerebral arteries and superior cerebellar arteries are patent. There is no evidence of focal stenosis or occlusion. There is no evidence of aneurysm or vascular malformation. Dural venous sinuses are patent. Impression: No evidence of significant stenosis, occlusion or vascular malformation. Attention Patients / Service-members: If you have questions or concerns about the results in this report, Please contact your ordering provider or primary care team. **********CT, HEAD/BRAIN (W/O CONTRAST)********** Status: Complete Procedure: CT, HEAD/BRAIN (W/O CONTRAST) Order Date: 05-Oct-2021 23:32:00 Order Comment: ED-22 Reason for Order: Abnormal paresthesias not fitting in typical anatomic distrubution Exam Date/Time: 06-Oct-2021 00:45:00 Transcription Date/Time: 06-Oct-2021 01:22:00 Status: COMPLETE Result Code: SEE RADIOLOGIST''S REPORT Approved Date/Time: 06-Oct-2021 01:22:00 Report Text: APPROVED DATE/TIME: 06 Oct 2021@0020 REASON: Abnormal paresthesias not fitting in typical anatomic distrubution STUDY CODE: CODE 1000 NO ALERT REQUIRED PROCEDURE: CT, HEAD/BRAIN (W/O CONTRAST) Technique: CT scan of the brain was obtained from skull base to vertex without contrast. Dose reduction techniques were utilized. Comparison: None. Findings: The ventricles and sulci are normal. There is a prominent cisterna magna. There is no cerebral or cerebellar edema. There is no evidence of intracranial hemorrhage or mass-effect. No extra-axial fluid collections are identified. Skull base and calvarium are intact. There is a prior right-sided canal wall up mastoidectomy. There is rounded soft tissue within the right mastoid bowl measuring 7 mm. There is fluid within the left mastoid cavity. There are bilateral maxillary sinus retention cysts. There is mild ethmoid sinus mucosal thickening. There is chronic appearing inflammatory debris right sphenoid sinus. There is near complete opacification of the right frontal sinus. Impression: No evidence of acute hemorrhage, edema or mass-effect. Additional findings, as above. Attention Patients / Service-members: If you have questions or concerns about the results in this report, Please contact your ordering provider or primary care team. **********PORT CHEST********** Status: Complete Procedure: PORT CHEST Order Date: 07-Oct-2021 10:35:00 Order Comment: ED-16 Reason for Order: CHEST PAIN Exam Date/Time: 07-Oct-2021 10:36:00 Transcription Date/Time: 07-Oct-2021 10:52:00 Status: COMPLETE Result Code: SEE RADIOLOGIST''S REPORT Approved Date/Time: 07-Oct-2021 10:46:00 Report Text: TECHNIQUE: Portable AP chest radiograph. COMPARISON: None available. FINDINGS: Tubes and lines: None. Lungs: The lungs are adequately inflated. Mildly prominent reticular interstitial lung markings. Pleura: There is no pneumothorax. There is no pleural effusion. Heart and mediastinum: Unremarkable. Bones/soft tissues: Unremarkable.. IMPRESSION: Nonspecific mildly increased reticular interstitial lung markings. This may be artifactual secondary to technique however, underlying viral infection is not entirely excluded. EKG: NSR, no STEMI. No ischemic changes noted.
CDC 'Split Type':

Write-up: Patient reports onset of symptoms after first vaccine 07SEP. Kept a log of symptoms in his phone. Notes that he was forced to receive vaccine. Recorded sx to include: "ear ringing, hearing loss, dizziness, mood fatigue, fatigue, sometimes sounds funny". 18Sep recorded "heart flutters while running, off balance, front of brain fuzzy, memory loss." 05OCT received second vaccination, recorded "Ringing in ear again, headache, front of brain feels numb, hard to focus, wife dropped off at hospital, heart flutters 1-2 min, show speaking, lost some feeling on left side of body, tremble shaking." Patient was evaluated at that time w/ CBC, CMP, CK, TSH, troponin, phos, mag, UA, UDS. CT head, CTA head, CTA neck performed w/o any abnormalities. All labs were WNL besides mildly elevated liver enzymes. EKG w/o any remarkable findings. Patient instructed to f/u with his PA. Had an appt with his PA this AM - afterwards noted "0915 numbness on L side of face, dull pain L chest, shot down arm (lasted 1 minute), subsided on its own. While in the waiting room had heartaches." Presented a second time to the ED. Upon further clarification - pt describes chest pain sx as a dull feeling in his L chest w/o associated nausea, diaphoresis, SOB or difficulty breathing. Lasted less that 1 min, not exertional. Describes numbness as "like goosebumps or when your foot goes numb." Currently has a headache, now 4-5/10 located at the center of his forehead. Has not taken any pain medications for this. No fevers/chills, nausea/vomiting, no weight loss or BM changes, no SOB, no abdominal pain. Feels like he''s had "slight inflammation" - has seasonal allergies. Felt lightheaded a few times while standing up quickly from a squat or sitting, no syncope/presyncope, no rashes/sores, no weakness. Neuro exam: CN2-12 intact. Does note decreased sensation (50%) in L side of face in opthalmic, maxillary, and mandibular distributions of trigeminal nerve. Motor fxn of trigeminal nerve is symmetric. Strength symmetric in face and bilateral upper and lower extremities. Sensation decreased in LUE and LLE (50%) compared to right. Normal gait. No cerebellar signs. Patient is a 45 y/o M w/ left-sided weakness and numbness after COVID vaccine 2 days ago, endorsing similar sx after first dose in early September. Presented initally 05OCT, CT head, CTA head, CTA neck nml. Symptoms concerning for stroke vs. TIA vs. brain lesion. ABCD2 score of 3 (elevated BP, long duration of numbness), low risk of stroke. NIHSS of 1. Patient has had many brief, transient symptoms since receiving first dose of Pfizer vaccine. Symptoms appear to vary in terms of character, temporality, and severity. CT head, CTA head, CTA neck, MRI head were performed, no e/o vascular injury, infarction, or stenosis. No brain lesions or inflammatory changes. Patient w/ unremarkable labs and otherwise healthy. Does have unilateral decrease in sensation in left face, arm, and leg on exam which are not readily explained given imaging and otherwise unremarkable exam. Chest pain not consistent with angina, normal EKG and troponins negative. With very low likelihood of ischemic event, patient can discharge home w/ f/u with his PA (has an appt this Tuesday). Neurology consult was placed to further evaluate decreased sensation in left face and left arm/leg.

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