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Report #2837509

Received Apr 23, 2025

DiedHospitalized
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
86 yrs
State
MN
Recovered
Not recovered
Vaccinated
Feb 18, 2021
Onset
Feb 28, 2025
Days to onset
1471
Hospital days
7

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (PFIZER-BIONTECH))PFIZER\BIONTECH2FF2589IM / LA

Symptoms (2)

COVID-19SARS-CoV-2 test positive

Symptom narrative

Hospitalization related to COVID 19 following completion of primary vaccine series

Current illness

Absent pedal pulses (R09.89) o Aortic stenosis, moderate (I35.0) o Callus of foot (L84) o Colostomy o Congestion of nasal sinus (R09.81) o Decreased sense of taste (R43.2) o Diastolic CHF (I50.30) o Dysuria (R30.0) o Fatigue (R53.83) o Foul smelling urine (R82.90) o History of claustrophobia (Z86.59) o History of dry mouth (Z87.898) o Hyperlipidemia (E78.5) o Hypertension (I10) o Ingrowing toenail (L60.0) o Insomnia (G47.00) o Irregular heart rate (I49.9) o Left leg swelling (M79.89) o Loss of smell (R43.0) o Nail deformity (L60.8) o Neck pain (M54.2) o Neuropathic pain of left shoulder (M79.2) o NSAID long-term use (Z79.1) o Onychogryphosis (L60.2) o Osteoarthritis of left hip, unspecified osteoarthritis type (M16.12) o Osteoporosis (M81.0) o Other specified abdominal hernia without obstruction or gangrene (K45.8) o Pain in joint of right shoulder (M25.511) o Parastomal hernia without obstruction or gangrene (K43.5) o Peripheral neuropathy (G62.9) o Positive ANA (antinuclear antibody) (R76.8) o Prediabetes (R73.03) o Raynauds phenomenon (I73.00) o Rectovaginal fistula (N82.3) o Right knee pain (M25.561) o Stage 3a chronic kidney disease (N18.31) o Suprapubic Cystostomy o Urinary incontinence (R32) o Venous insufficiency (I87.2) o Vesicovaginal fistula (N82.0

Medical history

Absent pedal pulses (R09.89) o Aortic stenosis, moderate (I35.0) o Callus of foot (L84) o Colostomy o Congestion of nasal sinus (R09.81) o Decreased sense of taste (R43.2) o Diastolic CHF (I50.30) o Dysuria (R30.0) o Fatigue (R53.83) o Foul smelling urine (R82.90) o History of claustrophobia (Z86.59) o History of dry mouth (Z87.898) o Hyperlipidemia (E78.5) o Hypertension (I10) o Ingrowing toenail (L60.0) o Insomnia (G47.00) o Irregular heart rate (I49.9) o Left leg swelling (M79.89) o Loss of smell (R43.0) o Nail deformity (L60.8) o Neck pain (M54.2) o Neuropathic pain of left shoulder (M79.2) o NSAID long-term use (Z79.1) o Onychogryphosis (L60.2) o Osteoarthritis of left hip, unspecified osteoarthritis type (M16.12) o Osteoporosis (M81.0) o Other specified abdominal hernia without obstruction or gangrene (K45.8) o Pain in joint of right shoulder (M25.511) o Parastomal hernia without obstruction or gangrene (K43.5) o Peripheral neuropathy (G62.9) o Positive ANA (antinuclear antibody) (R76.8) o Prediabetes (R73.03) o Raynauds phenomenon (I73.00) o Rectovaginal fistula (N82.3) o Right knee pain (M25.561) o Stage 3a chronic kidney disease (N18.31) o Suprapubic Cystostomy o Urinary incontinence (R32) o Venous insufficiency (I87.2) o Vesicovaginal fistula (N82.0

Other medications

amLODIPine Besylate 5 MG Oral TabletTAKE 1 TABLET BY MOUTH DAILYAmoxicillin-Pot Clavulanate 500-125 MG Oral TabletTAKE 1 TABLET 3 TIMES DAILY UNTIL GONE.Calcium 600-D 600-400 MG-UNIT TABSTake 1 tablet by mouth daily.Centrum TABSTAKE 1 TABLE

Allergies

No Known Environmental Allergies o No Known Food AllergiesDenied o Fosamax TABS

Lab data

Covid positive test date 2/28/25