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Report #2828447

Received Feb 26, 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
Female
Age
61 yrs
State
MN
Recovered
Recovered
Vaccinated
Apr 7, 2021
Onset
Feb 6, 2025
Days to onset
1401
Hospital days
5

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA2007B21AIM / LA

Symptoms (2)

COVID-19SARS-CoV-2 test positive

Symptom narrative

Hospitalization related to COVID 19 following completion of primary vaccine series

Current illness

???Anxiety (F41.9)???Arachnoid cyst (G93.0)???Chronic recurrent major depressive disorder (F33.9)???Dental abscess (K04.7)???Diabetic nephropathy (E11.21)???Diastolic congestive heart failure (I50.30)???Dyslipidemia (E78.5)???Elevated right ventricular end-diastolic pressure (R94.30)???Generalized osteoarthritis of unspecified site (M15.9)???Hearing loss (H91.90)???Hematuria (R31.9)???History of long-term treatment with high-risk medication (Z79.899)???Hypertension (I10)???Hypothyroidism (E03.9)???Mitral stenosis (I05.0)???Nicotine dependence (F17.200)???Nocturia (R35.1)???Obesity (E66.9)???Paroxysmal atrial fibrillation (I48.0)???Psoriasis (L40.9)???Pulmonary nodule (R91.1)???Rosacea (L71.9)???Sleep apnea (G47.30)???Type 2 diabetes mellitus (E11.9)???Urge and stress incontinence (N39.46)2

Medical history

???Anxiety (F41.9)???Arachnoid cyst (G93.0)???Chronic recurrent major depressive disorder (F33.9)???Dental abscess (K04.7)???Diabetic nephropathy (E11.21)???Diastolic congestive heart failure (I50.30)???Dyslipidemia (E78.5)???Elevated right ventricular end-diastolic pressure (R94.30)???Generalized osteoarthritis of unspecified site (M15.9)???Hearing loss (H91.90)???Hematuria (R31.9)???History of long-term treatment with high-risk medication (Z79.899)???Hypertension (I10)???Hypothyroidism (E03.9)???Mitral stenosis (I05.0)???Nicotine dependence (F17.200)???Nocturia (R35.1)???Obesity (E66.9)???Paroxysmal atrial fibrillation (I48.0)???Psoriasis (L40.9)???Pulmonary nodule (R91.1)???Rosacea (L71.9)???Sleep apnea (G47.30)???Type 2 diabetes mellitus (E11.9)???Urge and stress incontinence (N39.46)2

Other medications

amLODIPine Besylate 10 MG Oral TabletTAKE 1 TABLET BY MOUTH ONCE DAILYAmoxicillin-Pot Clavulanate 875-125 MG Oral TabletTAKE 1 TABLET EVERY 12 HOURS DAILY.Chantix Starting Month Pak 0.5 MG X 11 & 1 MG X 42 Oral TabletTAKE AS DIRECTED PER PA

Allergies

busPIRone, Codeine Derivatives

Lab data

Covid positive test date