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This is VAERS ID 902823

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 902823
VAERS Form:2
Age:73.0
Sex:Male
Location:West Virginia
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EU9899 / UNK LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Injection site erythema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxybutynin 5mg daily, Eliquis 5mg BID, Prazosin HCL 2mg QHS, Finasteride 5mg QHS, Imdur 15 g day, Zyrtec 10mg QHS, MOM 45ml daily, Klorcon 30mg BID, Lyrica 150mg BID, Lasix 80mg daily and 60mg QPM, UTI Stat 30ml daily, Flonase 50mg BID, Bu
Current Illness:
Preexisting Conditions: DM2, hx of PE, Central Cord Syndrome, Cervical Disc Degeneration
Allergies: Sulfa
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Redness at injection site


Changed on 12/24/2020

VAERS ID: 902823 Before After
VAERS Form:2
Age:73.0
Sex:Male
Location:West Virginia
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EU9899 / UNK LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Injection site erythema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxybutynin 5mg daily, Eliquis 5mg BID, Prazosin HCL 2mg QHS, Finasteride 5mg QHS, Imdur 15 g day, Zyrtec 10mg QHS, MOM 45ml daily, Klorcon 30mg BID, Lyrica 150mg BID, Lasix 80mg daily and 60mg QPM, UTI Stat 30ml daily, Flonase 50mg BID, Bu
Current Illness:
Preexisting Conditions: DM2, hx of PE, Central Cord Syndrome, Cervical Disc Degeneration
Allergies: Sulfa Sulfa
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Redness at injection site


Changed on 12/30/2020

VAERS ID: 902823 Before After
VAERS Form:2
Age:73.0
Sex:Male
Location:West Virginia
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EU9899 / UNK LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Injection site erythema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxybutynin 5mg daily, Eliquis 5mg BID, Prazosin HCL 2mg QHS, Finasteride 5mg QHS, Imdur 15 g day, Zyrtec 10mg QHS, MOM 45ml daily, Klorcon 30mg BID, Lyrica 150mg BID, Lasix 80mg daily and 60mg QPM, UTI Stat 30ml daily, Flonase 50mg BID, Bu
Current Illness:
Preexisting Conditions: DM2, hx of PE, Central Cord Syndrome, Cervical Disc Degeneration
Allergies: Sulfa Sulfa
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Redness at injection site


Changed on 5/7/2021

VAERS ID: 902823 Before After
VAERS Form:2
Age:73.0
Sex:Male
Location:West Virginia
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EU9899 / UNK LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Injection site erythema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxybutynin 5mg daily, Eliquis 5mg BID, Prazosin HCL 2mg QHS, Finasteride 5mg QHS, Imdur 15 g day, Zyrtec 10mg QHS, MOM 45ml daily, Klorcon 30mg BID, Lyrica 150mg BID, Lasix 80mg daily and 60mg QPM, UTI Stat 30ml daily, Flonase 50mg BID, Bu
Current Illness:
Preexisting Conditions: DM2, hx of PE, Central Cord Syndrome, Cervical Disc Degeneration
Allergies: Sulfa Sulfa
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Redness at injection site


Changed on 5/14/2021

VAERS ID: 902823 Before After
VAERS Form:2
Age:73.0
Sex:Male
Location:West Virginia
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EU9899 / UNK LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Injection site erythema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxybutynin 5mg daily, Eliquis 5mg BID, Prazosin HCL 2mg QHS, Finasteride 5mg QHS, Imdur 15 g day, Zyrtec 10mg QHS, MOM 45ml daily, Klorcon 30mg BID, Lyrica 150mg BID, Lasix 80mg daily and 60mg QPM, UTI Stat 30ml daily, Flonase 50mg BID, Bu
Current Illness:
Preexisting Conditions: DM2, hx of PE, Central Cord Syndrome, Cervical Disc Degeneration
Allergies: Sulfa Sulfa
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Redness at injection site

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