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Report #2824173

Received Feb 3, 2025

Hospitalized
A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex
Male
Age
72 yrs
State
MT
Recovered
Unknown
Vaccinated
Jan 26, 2021
Onset
Sep 29, 2021
Days to onset
246
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA2029L20AIM / LA

Symptoms (4)

Breakthrough COVID-19COVID-19 pneumoniaSARS-CoV-2 test positiveTreatment noncompliance

Symptom narrative

Reported Symptoms: 10067923:VACCINE BREAKTHROUGH INFECTION; Narrative: Patient was living independently for approximately one month following being a resident at a long term facility. Patient received two doses of the Moderna Covid-19 vaccine (12/29/2020 & 01/26/2021). On 09/28/2021 patient presented to an emergency department at a different facility where he tested positive for the COVID-19 infection. Patient had stopped taking all his home medications (including but limited to carbidopa/levodopa, quetiapine and ropinirole) without tapering or under the advisement of a physician due to his caretaker also being sick with the infection. Patient was transferred to the local facility for quarantine and supportive care. All medications were re-initiated. The COVID-19 pneumonia infection did not require any treatment. Patient had no where to discharge to until 10/14/2021 when he returned back to the long term care facility he had lived at previously. Other Relevant HX: Past medical history relevant for: T2DM, deep brain stimulation, GERD, parkinsonism, anxiety disorder, hyperlipidemia Other: COVID-19 Breakthrough Infection

Lab data

Positive COVID-19 PCR test (09/29/2021)