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You are viewing patients aged: 91, in state: WI

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VAERS_IDRECVDATESTATEAGE_YRSCAGE_YRCAGE_MOSEXRPT_DATESYMPTOM_TEXTDIEDDATEDIEDL_THREATER_VISITHOSPITALHOSPDAYSX_STAYDISABLERECOVDVAX_DATEONSET_DATENUMDAYSLAB_DATAV_ADMINBYV_FUNDBYOTHER_MEDSCUR_ILLHISTORYPRIOR_VAXSPLTTYPEFORM_VERSTODAYS_DATEBIRTH_DEFECTOFC_VISITER_ED_VISITALLERGIESLink 1Link 2
097077201/25/2021WI91Mreceived second dose at day 15; A spontaneous report was received from a pharmacist concerning a 91-year-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and received 2nd dose at day 15. The patient's medical history was not provided. Y12/28/202001/12/202115UNKMedical History/Concurrent Conditions: No adverse event (No medical history reported)USMODERNATX, INC.MOD20210201/25/20212021VAERSSYMPTOMS2021VAERSVAX
099708102/01/2021WI91.091F02/01/2021Pt suffered stroke on 1-23-21, 2 days after getting vaccine.YYU01/21/202101/23/20212OTHPUBunkunkunk12021VAERSSYMPTOMS2021VAERSVAX
101617702/09/2021WI91.091FFeb.4th 'shot area' inflamed and itchy. Redness about half around arm and 6 inches vertical. Feb. 9th(2 wk after) redness has faded. Red pimply itch spots appear.U01/26/202101/26/20210PVTLevothyroxine 25 mg., Bisoprolol-HCTZ2.5-6.25 mg., D-3 -50mcg.nonenone202/09/2021Amoxicillin, sulfa2021VAERSSYMPTOMS2021VAERSVAX
103396602/16/2021WI91.091Mpost vaccine fever, hypoxia, pulmonary embolismsY3U02/09/202102/10/20211SENMetformin, Levothyroxine, Aspirin 81mg, Sertraline, atrovastatUTItype 2 diabetes, hx stroke, hx covid (Nov. 2020)202/12/2021YNKA2021VAERSSYMPTOMS2021VAERSVAX
105252902/24/2021WI91.091FDizziness/vertigo, nausea, vomiting, chills started at about 7:30 am on 2/20/2021. This was the day after I received the vaccine. Nausea and vomiting subsided around noon. Chills were ongoing through out the day. On and off vertigo episodes continued Y02/19/202102/20/20211NonePVTEliquis 5 mg ; Aspirin 81 mg; Atorvastatin 10 mg; diltiazem 120 mg; benadryl 25 mg; colace 100 mg; lasix 20mg; melatonin 25mg; prilosec 40 mg;NoneAtrial fibrillation202/24/2021YAzithromycin2021VAERSSYMPTOMS2021VAERSVAX
105896302/26/2021WI91.091F2/182021: Witnessed cardiorespiratory arrest with PEA arrest upon EMS arrivalY02/18/2021N02/05/202102/18/202113PVTaortic sclerosis with stenosis as well as mitral and tricuspidSee above202/26/2021YProtonix and Piroxicam2021VAERSSYMPTOMS2021VAERSVAX
106330503/01/2021WI91.091MPatient presented to Medical Center on 02/23/2021 for weakness and fall. Patient had received his 1st Moderna COVID-19 vaccine on 02/22/2021. Was weak unable to rise out of the chair the next day. Patient has a history of COVID-19 in November of 2020. PaY1Y02/22/202102/23/20211PVTlevothyroxine 75 MCG tablet traZODone (DESYREL) 50 MG tablet melatonin 5 MG ASPIRIN 81 PO Ferrous Sulfate (IRON PO) allopurinol (ZYLOPRIM) 300 MG tablet amLODIPine (NORVASC) 5 MG tablet dutasteride (AVODART) 0.5 MG capsule omeprazolNone known.Benign prostatic hyperplasia with urinary obstruction Hyperactive airway disease Essential hypertension GERD Gout Insomnia secondary to depression with anxiety Depression Hypothyroidism DJD (degenerative joint disease), multiple sites Right knee DJD H/O hi203/01/2021YYLevaquin2021VAERSSYMPTOMS2021VAERSVAX
106979903/03/2021WI91.091Mmechanical fall during transfer from chair to wheel chair with family assist post vaccine monitoring. Blood noted to right ear . Family states frail skin. EMS assisted. No further follow up required per EMS and familyY03/03/202103/03/20210UNKunkmownunknownunknown203/03/2021none2021VAERSSYMPTOMS2021VAERSVAX
108602503/09/2021WI91FLosing eyesight in one eye; Has scratched cornea; She developed Bell's Palsy; She developed shingles; A spontaneous report was received from a relative concerning a 91-year old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and develU01/30/202102/09/202110UNKVITAMIN D [COLECALCIFEROL]; EQUATE 8HR ARTHRITIS PAIN RELIEF; LOSARTAN POTASSIUM; VITAMINS NOSBlindness, one eye (Blindness in one eye after laser surgery)Medical History/Concurrent Conditions: Eye laser surgery (Blindness in one eye after laser surgery)USMODERNATX, INC.MOD20210203/08/2021Y2021VAERSSYMPTOMS2021VAERSVAX
113043303/24/2021WI91.091FPatient was vaccinated at a senior residence. She was a new patient that had just transferred facilities and it was not noted in the chart that she had previously received a COVID-19 Vaccine so her first dose of Moderna was on 3/11/21 and she received anoU03/24/202103/24/20210SEN203/24/20212021VAERSSYMPTOMS2021VAERSVAX
113790103/26/2021WI91.091FI was tired, then I got an awful headache, couldn't sleep. Tired, nauseous when I moved, No arm soreness. It comes and goes. I am a very healthy person and this is not like me.N02/19/202103/23/202132I haven't seen anyone about this.PVTonly thyroid pill in the morningnonenone203/26/2021only amoxicillen.2021VAERSSYMPTOMS2021VAERSVAX
113990703/27/2021WI91.091FPatient received vaccine in the morning and by the time the patient went to bed she reports feeling almost like she was paralyzed/ heavy feeling in her limbs, trouble standing and walking, and feeling very lethargic. She called her son the next morning andU03/26/202103/26/20210Suggested patient seek further care, unknown if this has occurredPHMlevothyroxine203/27/2021Y2021VAERSSYMPTOMS2021VAERSVAX
121349004/15/2021WI91.091MHospitalized secondary to PE 4 days post vaccination.Y1U04/10/202104/13/20213PVT204/15/2021YY2021VAERSSYMPTOMS2021VAERSVAX
127797805/01/2021WI91.091MDad woke up one morning in February with a a pain in his groin so severe he could not swing the leg forward to walk. He used a walk-behind walker to get around for several weeks. Eventually he could walk without support, but only if careful. The pain woN02/03/202102/01/2021PUBatorvastatin, flomax, warfarin, nitroglycerin, vitamin Dnoneprior stroke ( 5 years ago)205/01/2021none2021VAERSSYMPTOMS2021VAERSVAX
132679105/18/2021WI91.091FSon states that on February 7th his mother developed shingles. On February 12th developed Bell's Palsy. On May 15th at 9:00 PM his mother had a heart attack. Is recovering at healthcare facility.Y401/30/202105/07/202197PVTSon reported this. States she may have been taking some medication for hypertension at the time. Is no longer.None known.History of HTN. Blindness in right eye prior to vaccination.205/18/2021YYNone known.2021VAERSSYMPTOMS2021VAERSVAX
134735605/25/2021WI91.091FPatient presented to the ED on 3/6/21. Patient hospitalized on 4/22/21. These visits are within 6 weeks of receiving COVID vaccination.Y404/01/202104/22/202121OTH205/25/2021Y2021VAERSSYMPTOMS2021VAERSVAX
137727306/07/2021WI91.091FPt received first dose of COVID-19 vaccine on 5/8/21, pt later became ill with COVID19, presenting to ED for testing on 5/22/2021 but was not admitted at this time because symptoms were more mild and manageable at home. Returned to ED on 5/26 and at this Y6Y05/08/202105/26/202118PVTalendronate, amlodipine, aspirin, atenolol, atorvastatin, calcium-vitamin D, clopidogrel, Cyanocobalamin IM monthly, oral Cyanocobalamin daily, isosorbide monotirate, vitamin D.Arteriosclerotic heart disease, hyperlipidemia, hypertension, Chronic heart failure with preserved ejection fraction, Hx of NSTEMI, HX malignant colon tumor, iron deficiency anemia, hx breast cancer, DM2, vitamin B12 deficiency, mixed anxiety and depressiv206/07/2021Benazepril, Mirtazapine2021VAERSSYMPTOMS2021VAERSVAX
139588706/14/2021WI91.091FExactly two weeks following the vaccine, the patient broke out in both upper arms which she described as similar to hives. She has been diagnosed with agranular accura. She had little red marks on her skin that she described as very itchy.N06/01/202106/14/202113NonePHMNone reportedNoneAgranular accura206/14/2021YStatin, Sulfa antibiotics, Penicillins2021VAERSSYMPTOMS2021VAERSVAX
144634407/03/2021WI91.091MLungs filled up - CT scan looked like glass - similar to COVID19 patients Had multiple COVID 19 tests all negative o2 levels very low in hospital for 12 nights to stablezizeY06/05/2021Y12N02/01/202104/01/202159CT O2 Echo Cardio Gram PT OT Xrays Blood work Fungal testsPVTEliquis Vitamin D Synthro Lasix MetapropolnoneTAVR 2/2020 no other health issuesfever, chills, from 1st vaccine207/03/2021none2021VAERSSYMPTOMS2021VAERSVAX
145659907/08/2021WI91.091MShingrix dose in question: Jan 1st 2019/ Shingrix confirmed dose: 4/7/2021; This case was reported by a other health professional via call center representative and described the occurrence of drug dose administration interval too long in a 91-year-old malU04/07/202104/07/20210UNKUSGLAXOSMITHKLINEUS202100207/07/20212021VAERSSYMPTOMS2021VAERSVAX
157417808/16/2021WI91.091MAdmitted to hospital on 8/10/2021 with confirmed Covid, symptoms of generalized weakness, increased SOB, exhaustion and fever. Dose # 1 given 2/24/21 Dose#2 given 3/17/2021YY603/17/202108/10/2021146PVTAnemia ? Anticoagulant long-term use 1/2/2007 ? Anxiety ? Bronchial asthma ? CAD (coronary artery disease) ? Cardiac pacemaker 5/29/2018 ? Chronic back pain ? CKD (chronic kidney disease) stage 3, GFR 30-59 ml/min (CMS/HCC) ? COPD (chronic obst208/16/2021Plavix, contrast dye, Nexium, NSAIDS2021VAERSSYMPTOMS2021VAERSVAX
159187908/20/2021WI91.091FPatient is a 91-year-old female who presents today for evaluation of having a sore throat for the last 2-3 days with voice becoming more hoarse. No drooling. No dyspnea. She has rhinorrhea, congestion and a dry cough. No known ill contacts. Patient ha02/19/202108/17/2021179Contains critical data CORONAVIRUS (COVID 19) PCR Order: 276069873 Status: Final result Specimen Information: NASOPHARYNGEAL SWAB 0 Result Notes Ref Range & Units 8/19/21 0250 CORONAVIRUS SARS COV 2 PCR (RESP) NEGATIVE POSITIVE PanicUNK208/20/2021Y2021VAERSSYMPTOMS2021VAERSVAX
167008909/03/2021WI91.091MClient's symptom onset for COVID-19 was on 8/9/21 and included cough, nausea, fatigue, ABD pain, pneumonia, fever, weakness, and dehydration. He tested positive for COVID-19 on 8/11/21. Client was hospitalized on 8/12/21. Client passed away on 8/25/21.Y08/25/2021Y14N01/28/202108/12/2021196UNKCardiac disease209/03/20212021VAERSSYMPTOMS2021VAERSVAX
175333210/01/2021WI91.091FFever began on 9/30/2021 at 0426 of 99.4. Throughout the day of 9/30/2021 continually increased to 103.0 at 2120. Given tylenol and fever has subsided. 10/1/2021 at 0823 98.1.U09/29/202109/30/20211SEN210/01/20212021VAERSSYMPTOMS2021VAERSVAX
175374510/01/2021WI91.091MPatient completed Pfizer COVID-19 vaccine series on 2/20/21. Patient presented to reporting hospital ER on 9/29/21 after complaint of weakness and was admitted for COVID and Troponinemia. He is currently not requiring oxygen. His symptoms were mild cough aYU02/20/202109/29/2021221COVID-19 PCR NP swab positive 9/29/21UNKAspirin 81mg, Alphagan 0.2% ophthalmic soln, Trusopt 2% ophthalmic solution, Proscar 5mg, mevacor 40 mg, flomax 0.4mgBPH, dyslipidemia, arthritisBPH, dyslipidemia, arthritis210/01/2021None2021VAERSSYMPTOMS2021VAERSVAX
178279410/13/2021WI91.091FPatient contracted COVID after being fully vaccinated Cough, Fever, and CongestionY02/23/202110/08/2021227Procalcitonin (Normal), CBC (normal), CMP (normal), BNP (High), Troponin (Normal), Magnesium Level CT Thorax w/ Contrast (abnormal) 1 view chest xray (abnormal)PHMamlodipine 5mg daily calcium-vitamin D BID Citalopram 10mg HS Metoprolol 100mg BID Multivitamin with minerals Daily Warfarin 6.5mg dailyNone DocumentedHypertension, Gastroesophageal reflux disease, colon polyps, disorder of the bladder, overactive bladder, menopause, osteoporosis, eczema, anxiety, chronic pain, varicose veins, arthritis, hyperlipidemia, Lichen simplex chronicus, Diverticulosis of the col210/13/2021Azithromycin - Side Effect - Elevated INR2021VAERSSYMPTOMS2021VAERSVAX
178312410/13/2021WI91.091MAdmitted to hospital on 9/14/2021 with SOB, cough, hypoxia. Had been recommended monoclonal antibiotic therapy, but had not been initiated. DX: acute hypoxic respiratory failure, c-19 pneumonia. on 15 L O2, Decadron, declined intubation. 9/16/2021 awaitingY09/18/2021YN02/19/202109/14/20212079/6/2021 Covid positive per antigen 9/14/2021 CT ground glass opacities, likely bronchogenic carcinoma, possible renal cell carcinomaUNKUnknownUnknownHx prostate CA, anemia, CKD, HTN, PVD210/13/2021Unknown2021VAERSSYMPTOMS2021VAERSVAX