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This is VAERS ID 919546

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 919546
VAERS Form:2
Age:51.0
Sex:Female
Location:Alabama
Vaccinated:2020-12-29
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Aphasia, Blood cholesterol increased, Coagulation time, Craniotomy, Low density lipoprotein increased, Thrombotic stroke, Antiphospholipid antibodies, Antinuclear antibody positive, Blood homocysteine, Mechanical ventilation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Plaquenil Fioricet Midrin
Current Illness: PMH- Lupus; HTN; marked hyperlipidemia
Preexisting Conditions: Lupus Hypertension Hyperlipidemia
Allergies: None listed
Diagnostic Lab Data: Total cholesterol- 465 LDL- 351 ANA (+) Labs pending- Lupus AC; antiphospholipid AB, homocysteine levels; hypercoagulability profile
CDC 'Split Type':

Write-up: thrombotic stroke -necessitating hospitalization; and craniotomy; required mechanical ventilator for 2 days. Patient now extubated, breathing on her own. Patient remains hospitalized with marked deficits (aphasic)


Changed on 5/7/2021

VAERS ID: 919546 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Alabama
Vaccinated:2020-12-29
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Aphasia, Blood cholesterol increased, Coagulation time, Craniotomy, Low density lipoprotein increased, Thrombotic stroke, Antiphospholipid antibodies, Antinuclear antibody positive, Blood homocysteine, Mechanical ventilation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Plaquenil Fioricet Midrin
Current Illness: PMH- Lupus; HTN; marked hyperlipidemia
Preexisting Conditions: Lupus Hypertension Hyperlipidemia
Allergies: None listed listed
Diagnostic Lab Data: Total cholesterol- 465 LDL- 351 ANA (+) Labs pending- Lupus AC; antiphospholipid AB, homocysteine levels; hypercoagulability profile
CDC 'Split Type':

Write-up: thrombotic stroke -necessitating hospitalization; and craniotomy; required mechanical ventilator for 2 days. Patient now extubated, breathing on her own. Patient remains hospitalized with marked deficits (aphasic)


Changed on 5/14/2021

VAERS ID: 919546 Before After
VAERS Form:2
Age:51.0
Sex:Female
Location:Alabama
Vaccinated:2020-12-29
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Aphasia, Blood cholesterol increased, Coagulation time, Craniotomy, Low density lipoprotein increased, Thrombotic stroke, Antiphospholipid antibodies, Antinuclear antibody positive, Blood homocysteine, Mechanical ventilation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Plaquenil Fioricet Midrin
Current Illness: PMH- Lupus; HTN; marked hyperlipidemia
Preexisting Conditions: Lupus Hypertension Hyperlipidemia
Allergies: None listed listed
Diagnostic Lab Data: Total cholesterol- 465 LDL- 351 ANA (+) Labs pending- Lupus AC; antiphospholipid AB, homocysteine levels; hypercoagulability profile
CDC 'Split Type':

Write-up: thrombotic stroke -necessitating hospitalization; and craniotomy; required mechanical ventilator for 2 days. Patient now extubated, breathing on her own. Patient remains hospitalized with marked deficits (aphasic)

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