VAERS ID: |
989988 (history) |
Form: |
Version 2.0 |
Age: |
52.0 |
Sex: |
Male |
Location: |
Michigan |
Vaccinated: | 2021-01-10 |
Onset: | 2021-01-11 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-31 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / 2 |
LA / IM |
Administered by: Private Purchased by: ? Symptoms: Blindness unilateral,
COVID-19,
Cerebrovascular accident,
Ophthalmic artery thrombosis,
Retinal artery occlusion,
Retinal artery thrombosis,
Retinal infarction,
Retinogram abnormal,
Visual impairment SMQs:, Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Other Medications: doxepin in evening for sleep 5mg asprin 325mg daily Current Illness: Covid 19 infection diagnosed 12/23/2020 Preexisting Conditions: angioedema periodic due to sulfite allergy Allergies: sulfites- angioedema Diagnostic Lab Data: Opthomology retinal vessel scans showing reduced blood flow in left eye and infarted areas of retina. CDC Split Type:
Write-up: Diagnosed day after 2nd shot with opthalmic artery thrombus causing vision loss/change in left eye. I did get shot series on 12/22/2020 #1 and 1/10/2021 and was diagnosed with Covid-19 on 12/13/2020. My internist MD did not feel the vaccine caused the thrombus /Stroke but I wanted to report it as it was associated with the vaccine administration (symptoms of vision loss within 24 hours of the vaccine #2 administration). |