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This is VAERS ID 903495

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 903495
VAERS Form:2
Age:45.0
Sex:Male
Location:New Mexico
Vaccinated:2020-12-17
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chills, Diarrhoea, Headache, Pain, Pain in extremity, Pyrexia, Swelling

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Right arm soreness, mild swelling, subjective fever, chills, bodyaches, headaches, loose stools x 2, 6 hours of duration, Treatment Tylenol


Changed on 12/30/2020

VAERS ID: 903495 Before After
VAERS Form:2
Age:45.0
Sex:Male
Location:New Mexico
Vaccinated:2020-12-17
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Chills, Diarrhoea, Headache, Pain, Pain in extremity, Pyrexia, Swelling

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)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Right arm soreness, mild swelling, subjective fever, chills, bodyaches, headaches, loose stools x 2, 6 hours of duration, Treatment Tylenol

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=903495&WAYBACKHISTORY=ON


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