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This is VAERS ID 910059

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2020

VAERS ID: 910059
VAERS Form:2
Age:37.0
Sex:Female
Location:Kentucky
Vaccinated:2020-12-23
Onset:0000-00-00
Submitted:0000-00-00
Entered:2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Gait inability, Hypoaesthesia, Pyrexia, Respiratory failure, Endotracheal intubation, Acute kidney injury

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)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cetirezen 10 mg Daily, Lasix 20 Mg daily, Gabapentin 400 bid, Glipizide 5 mg daily, lisnopril 5 mg daily, Levothyroxine25mcg daily, Metoxican 7.5 daily, Sertraline 50 daily
Current Illness: none
Preexisting Conditions: Depression, Diabetes ,Hypertension, Hypothyroidism, Obesity
Allergies: Pencillian
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Numbness in sole of feet. Unable to walk, develop high fever, resp failure resulting in intubation, acute kidney injury


Changed on 5/7/2021

VAERS ID: 910059 Before After
VAERS Form:2
Age:37.0
Sex:Female
Location:Kentucky
Vaccinated:2020-12-23
Onset:0000-00-00
Submitted:0000-00-00
Entered:2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Gait inability, Hypoaesthesia, Pyrexia, Respiratory failure, Endotracheal intubation, Acute kidney injury

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)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cetirezen 10 mg Daily, Lasix 20 Mg daily, Gabapentin 400 bid, Glipizide 5 mg daily, lisnopril 5 mg daily, Levothyroxine25mcg daily, Metoxican 7.5 daily, Sertraline 50 daily
Current Illness: none
Preexisting Conditions: Depression, Diabetes ,Hypertension, Hypothyroidism, Obesity
Allergies: Pencillian Pencillian
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Numbness in sole of feet. Unable to walk, develop high fever, resp failure resulting in intubation, acute kidney injury


Changed on 5/14/2021

VAERS ID: 910059 Before After
VAERS Form:2
Age:37.0
Sex:Female
Location:Kentucky
Vaccinated:2020-12-23
Onset:0000-00-00
Submitted:0000-00-00
Entered:2020-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20A / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Gait inability, Hypoaesthesia, Pyrexia, Respiratory failure, Endotracheal intubation, Acute kidney injury

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)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cetirezen 10 mg Daily, Lasix 20 Mg daily, Gabapentin 400 bid, Glipizide 5 mg daily, lisnopril 5 mg daily, Levothyroxine25mcg daily, Metoxican 7.5 daily, Sertraline 50 daily
Current Illness: none
Preexisting Conditions: Depression, Diabetes ,Hypertension, Hypothyroidism, Obesity
Allergies: Pencillian Pencillian
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Numbness in sole of feet. Unable to walk, develop high fever, resp failure resulting in intubation, acute kidney injury

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=910059&WAYBACKHISTORY=ON


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