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This is VAERS ID 1771979

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1771979
VAERS Form:2
Age:49.0
Sex:Female
Location:Ohio
Vaccinated:2021-08-25
Onset:2021-10-04
Submitted:0000-00-00
Entered:2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 052E / 2 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UJ686AA / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Back pain, Chest pain, Chest X-ray abnormal, Computerised tomogram abnormal, Cough, Electrocardiogram normal, Fibrin D dimer increased, Neck pain, Pain, Pulmonary embolism, Pulmonary oedema, Anticoagulant therapy, Laboratory test normal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 5 mg prednisone
Current Illness:
Preexisting Conditions: Thyroid Eye Disease
Allergies: cefnidir & macrobid - GI issues
Diagnostic Lab Data: D-Dimer .62 Chest X-Ray - shows fluid in lower right lung CAT scan shows pulmonary embolism
CDC 'Split Type':

Write-up: 10/4/2021 - Sudden stabbing pain in upper right chest. Radiates to neck and back, right side 10/5-10/6 - pain subsides, but coughing 10/7 - Stabbing pain in upper right chest more severe, scheduled appointment with PCP 10/7 - PCP (Primary Care Physician) did EKG, D-Dimer and Chest X-ray. D-Dimer positive; X-ray shows fluid in bottom of right lung. PCP orders CAT scan 10/8 CAT scan shows pulmonary embolism. EKG and other heart health tests come back normal. Sent home with 20mg/day apixaban (blood thinner). NOTE: no history of clotting, no risk factors for clotting.

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