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This is VAERS ID 1782324

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1782324
VAERS Form:2
Age:92.0
Sex:Female
Location:New York
Vaccinated:2021-02-15
Onset:2021-10-09
Submitted:0000-00-00
Entered:2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN9581 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Dyspnoea, Vaccine breakthrough infection, COVID-19, SARS-CoV-2 test positive

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions: CAD, A-fibb, CHF, DM, HTN
Allergies: Morphine
Diagnostic Lab Data: COVID-19 positive
CDC 'Split Type':

Write-up: Patient admitted to hospital with breakthrough COVID-19 case. Increasing SOB. 87% on room air.

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