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From the 6/4/2021 release of VAERS data:

This is VAERS ID 908869



Case Details

VAERS ID: 908869 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2020-12-18
Onset:2020-12-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2020-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood bilirubin increased, Blood creatinine increased, Contusion, Immunoglobulin therapy, International normalised ratio normal, Metabolic function test normal, Petechiae, Platelet count decreased, Platelet transfusion, Prothrombin time normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Biliary system related investigations, signs and symptoms (narrow), Accidents and injuries (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Comprehensive list displayed in additional information below. ascorbic acid daily, atorvastatin 40mg daily, cholecalciferol daily, docusate 100mg daily, levothyroxine 100mcg daily, losartan 100mg daily, zinc 50mg daily
Current Illness: Vague symptoms (anorexia, fatigue) 11/29/2020 - 12/6/2020; Received high-dose influenza vaccination on 11/25/2020 at employee health department. On 11/29/2020 patient began having generalized fatigue, anorexia, and occasional chills. Presented to Urgent care on 12/4/2020 and reported same symptoms for past 5 days with 10-12 lb weight loss and worsening fatigue. Pfizer rapid PCR COVID test negative. Patient''s symptoms improved and he returned to normal activities of daily living until 12/19/2020, 1 day after COVID19 vaccination.
Preexisting Conditions: HTN, Type II Diabetes
Allergies: NKDA
Diagnostic Lab Data: 12/21/2020 CBC: platelets of 1,000
CDC Split Type:

Write-up: 12/18/2020: COVID19 vaccine received. 12/19/2020: Patient noticed petechiae/bruising on arms, legs and face. Worsened over next 48 hours. 12/21/2020: Patient had blood drawn (CMP, PT/INR, CBC) at lab. 12/22/2020: Labs resulted; CMP and PT/INR WNL (exceptions: SCr 1.24, TBil 1.7); CBC with platelet count of 1,000 resulting in patient admission to Hospital. At admission he received 80 mg of prednisone, 40 g of IV Ig and a unit of platelets. 12/23/2020: Continued hospitalization. Patient''s platelets improved to 20,000 and he received another 35g of IV Ig. 12/24/2020: Patient discharged with platelets of 38,000.


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