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This is VAERS ID 1782695

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1782695
VAERS Form:2
Age:71.0
Sex:Male
Location:Kentucky
Vaccinated:2021-03-29
Onset:2021-10-09
Submitted:0000-00-00
Entered:2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Acute respiratory failure, Blood sodium decreased, Blood urea increased, Chest X-ray abnormal, Cough, Dyspnoea, Dyspnoea exertional, Fatigue, Fibrin D dimer, Lung infiltration, Oxygen saturation, Pain, Pyrexia, Sick relative, White blood cell count increased, Vaccine breakthrough infection, COVID-19, SARS-CoV-2 test positive, COVID-19 pneumonia, Exposure to SARS-CoV-2

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: ALZHEIMER''S, CAD, GERD,HYPERLIPIDEMIA
Allergies: APPLE, PEACH FLAVOR AND TOMATO
Diagnostic Lab Data: SAR-COV2 NAAT-POSITIVE, CXR-BILATERAL PULMONARY INFILTRATES, 02 SAT 85% ON ROOM AIR. D-DIMER-1.50, WBC-15.9, CO2-19, BUN-24, SODIUM-133,
CDC 'Split Type':

Write-up: BREAKTHROUGH HOSPITALIZATION CASE. VACCINATED FOR COVID-19 IN MARCH 2021. 10/9/21-STARTED HAVING SOB AND FATIGUE INCREASING IN SEVERITY, THEN HE PRESENTED IN THE ER ON 10/10/21. HE C/O HAVING BODY ACHES, FATIGUE, NON-PRODUCTIVE COUGH AND SOB WITH EXERTION. TEMP 102.7F. HIS WIFE TESTED POSITIVE FOR COVID-19 SEVERAL DAYS BEFORE. HIS TEST WAS NEGATIVE AT THAT TIME. HE WAS TESTED AGAIN IN THE ER AND WAS POSITIVE FOR COVID-19. HE IS A FORMER SMOKER. HE WAS STARTED ON 2L OF O2. HE WAS DIAGNOSED WITH ACUTE HYPOXEMIC RESPIRATORY FAILURE, COVID-19 VIRUS INFECTION AND PNEUMONIA DUE TO COVID-19 VIRUS.

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