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This is VAERS ID 946978

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/22/2021

VAERS ID: 946978
VAERS Form:2
Age:49.0
Sex:Male
Location:Florida
Vaccinated:2020-12-29
Onset:2021-01-03
Submitted:0000-00-00
Entered:2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA LOT#026L20A / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Asthenia, Chest X-ray normal, Cough, Dyspnoea, Dyspnoea exertional, Fatigue, Fibrin D dimer increased, Heart rate increased, Intensive care, Oxygen saturation decreased, Pneumonia, Pulmonary embolism, Respiratory distress, Thrombolysis, Ultrasound Doppler abnormal, Deep vein thrombosis, Anticoagulant therapy, Computerised tomogram thorax abnormal, SARS-CoV-2 test negative

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)? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: lexothyroxine, vitamin D, montelukast, manesium citrate
Current Illness: Sinus infection at the beginning of December treated with augmentin
Preexisting Conditions: hypothyroidism, allergic rhinitis
Allergies: NKDA
Diagnostic Lab Data: PCR covid test 1/4/21 negative Chest Xray 1/6/21 negative at the ER at the Medical Center on 1/10/21 d-dimer levels were very high, chest CT showed multiple bilateral pulmonary emboli, leg US revealed bilateral emboli
CDC 'Split Type':

Write-up: Onset of shortness of breath and cough on 1/3 that progressively got worse. Clinical diagnosis of pneumonia without fever was made, patient started azithromycin on 1/5 and albuterol treatments every 4-6 hrs. Initially he improved, but then worsened. chest xray on 1/6 was negative for pneumonia, PCR covid test was negative, albuterol treatment did not bring much relief. He started respiratory distress on 1/10 and was taken by car to the local ER where another covid test was negative and chest CT revealed multiple bilateral pulmonary emboli. The leg US revealed blood clots in both of his legs. He had an emergency catheter-delivered thrombolysis and was discharged home from the ICU on 1/12 on oral anticoagulants. He is gradually improving, but very weak. He tires easily and gets a drop in oxygen to 90- 93%, as well as an increase in the heart rate to 120 when walking less than half a mile. He runs out of breath with exertion.


Changed on 5/7/2021

VAERS ID: 946978 Before After
VAERS Form:2
Age:49.0
Sex:Male
Location:Florida
Vaccinated:2020-12-29
Onset:2021-01-03
Submitted:0000-00-00
Entered:2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA LOT#026L20A / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Asthenia, Chest X-ray normal, Cough, Dyspnoea, Dyspnoea exertional, Fatigue, Fibrin D dimer increased, Heart rate increased, Intensive care, Oxygen saturation decreased, Pneumonia, Pulmonary embolism, Respiratory distress, Thrombolysis, Ultrasound Doppler abnormal, Deep vein thrombosis, Anticoagulant therapy, Computerised tomogram thorax abnormal, SARS-CoV-2 test negative

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)? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: lexothyroxine, vitamin D, montelukast, manesium citrate
Current Illness: Sinus infection at the beginning of December treated with augmentin
Preexisting Conditions: hypothyroidism, allergic rhinitis
Allergies: NKDA NKDA
Diagnostic Lab Data: PCR covid test 1/4/21 negative Chest Xray 1/6/21 negative at the ER at the Medical Center on 1/10/21 d-dimer levels were very high, chest CT showed multiple bilateral pulmonary emboli, leg US revealed bilateral emboli
CDC 'Split Type':

Write-up: Onset of shortness of breath and cough on 1/3 that progressively got worse. Clinical diagnosis of pneumonia without fever was made, patient started azithromycin on 1/5 and albuterol treatments every 4-6 hrs. Initially he improved, but then worsened. chest xray on 1/6 was negative for pneumonia, PCR covid test was negative, albuterol treatment did not bring much relief. He started respiratory distress on 1/10 and was taken by car to the local ER where another covid test was negative and chest CT revealed multiple bilateral pulmonary emboli. The leg US revealed blood clots in both of his legs. He had an emergency catheter-delivered thrombolysis and was discharged home from the ICU on 1/12 on oral anticoagulants. He is gradually improving, but very weak. He tires easily and gets a drop in oxygen to 90- 93%, as well as an increase in the heart rate to 120 when walking less than half a mile. He runs out of breath with exertion.


Changed on 5/14/2021

VAERS ID: 946978 Before After
VAERS Form:2
Age:49.0
Sex:Male
Location:Florida
Vaccinated:2020-12-29
Onset:2021-01-03
Submitted:0000-00-00
Entered:2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA LOT#026L20A / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Asthenia, Chest X-ray normal, Cough, Dyspnoea, Dyspnoea exertional, Fatigue, Fibrin D dimer increased, Heart rate increased, Intensive care, Oxygen saturation decreased, Pneumonia, Pulmonary embolism, Respiratory distress, Thrombolysis, Ultrasound Doppler abnormal, Deep vein thrombosis, Anticoagulant therapy, Computerised tomogram thorax abnormal, SARS-CoV-2 test negative

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)? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: lexothyroxine, vitamin D, montelukast, manesium citrate
Current Illness: Sinus infection at the beginning of December treated with augmentin
Preexisting Conditions: hypothyroidism, allergic rhinitis
Allergies: NKDA NKDA
Diagnostic Lab Data: PCR covid test 1/4/21 negative Chest Xray 1/6/21 negative at the ER at the Medical Center on 1/10/21 d-dimer levels were very high, chest CT showed multiple bilateral pulmonary emboli, leg US revealed bilateral emboli
CDC 'Split Type':

Write-up: Onset of shortness of breath and cough on 1/3 that progressively got worse. Clinical diagnosis of pneumonia without fever was made, patient started azithromycin on 1/5 and albuterol treatments every 4-6 hrs. Initially he improved, but then worsened. chest xray on 1/6 was negative for pneumonia, PCR covid test was negative, albuterol treatment did not bring much relief. He started respiratory distress on 1/10 and was taken by car to the local ER where another covid test was negative and chest CT revealed multiple bilateral pulmonary emboli. The leg US revealed blood clots in both of his legs. He had an emergency catheter-delivered thrombolysis and was discharged home from the ICU on 1/12 on oral anticoagulants. He is gradually improving, but very weak. He tires easily and gets a drop in oxygen to 90- 93%, as well as an increase in the heart rate to 120 when walking less than half a mile. He runs out of breath with exertion.

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