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This is VAERS ID 903638

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 903638
VAERS Form:2
Age:62.0
Sex:Male
Location:Massachusetts
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 EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Feeling abnormal, Hypoaesthesia, Transient ischaemic attack, Vision blurred

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Truvada 200 mg, Protonix 40 mg, Tylenol 650 mg, ASA 81 mg, Lipitor 10 mg, Omnipaque 350mg, Lisinopril 10 mg, Zofran 4 mg
Current Illness: none
Preexisting Conditions: HTN
Allergies: NKDA
Diagnostic Lab Data: admitted to hospital TIA
CDC 'Split Type':

Write-up: Patient is a very pleasant 62 year old gentleman with a history of HTN, hyperlipidemia who presented with left facial numbness and left UE numbness. He states that it is worse medially on his arm. Present in upper and lower face. He states it started around 730 am this morning. He also notes intermittent "foggy" sensation since Monday associated with some blurred vision that comes and goes. Denies focal weakness, unsteady gait, difficulty with speech and swallow. He denies f/c, cp, sob, rash, pruritis, n/v/d, edema. He did receive the Pfizer COVID vaccine yesterday


Changed on 12/30/2020

VAERS ID: 903638 Before After
VAERS Form:2
Age:62.0
Sex:Male
Location:Massachusetts
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 EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Feeling abnormal, Hypoaesthesia, Transient ischaemic attack, Vision blurred

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Truvada 200 mg, Protonix 40 mg, Tylenol 650 mg, ASA 81 mg, Lipitor 10 mg, Omnipaque 350mg, Lisinopril 10 mg, Zofran 4 mg
Current Illness: none
Preexisting Conditions: HTN
Allergies: NKDA NKDA
Diagnostic Lab Data: admitted to hospital TIA
CDC 'Split Type':

Write-up: Patient is a very pleasant 62 year old gentleman with a history of HTN, hyperlipidemia who presented with left facial numbness and left UE numbness. He states that it is worse medially on his arm. Present in upper and lower face. He states it started around 730 am this morning. He also notes intermittent "foggy" sensation since Monday associated with some blurred vision that comes and goes. Denies focal weakness, unsteady gait, difficulty with speech and swallow. He denies f/c, cp, sob, rash, pruritis, n/v/d, edema. He did receive the Pfizer COVID vaccine yesterday


Changed on 5/7/2021

VAERS ID: 903638 Before After
VAERS Form:2
Age:62.0
Sex:Male
Location:Massachusetts
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 EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Feeling abnormal, Hypoaesthesia, Transient ischaemic attack, Vision blurred

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Truvada 200 mg, Protonix 40 mg, Tylenol 650 mg, ASA 81 mg, Lipitor 10 mg, Omnipaque 350mg, Lisinopril 10 mg, Zofran 4 mg
Current Illness: none
Preexisting Conditions: HTN
Allergies: NKDA NKDA
Diagnostic Lab Data: admitted to hospital TIA
CDC 'Split Type':

Write-up: Patient is a very pleasant 62 year old gentleman with a history of HTN, hyperlipidemia who presented with left facial numbness and left UE numbness. He states that it is worse medially on his arm. Present in upper and lower face. He states it started around 730 am this morning. He also notes intermittent "foggy" sensation since Monday associated with some blurred vision that comes and goes. Denies focal weakness, unsteady gait, difficulty with speech and swallow. He denies f/c, cp, sob, rash, pruritis, n/v/d, edema. He did receive the Pfizer COVID vaccine yesterday


Changed on 5/14/2021

VAERS ID: 903638 Before After
VAERS Form:2
Age:62.0
Sex:Male
Location:Massachusetts
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 EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Feeling abnormal, Hypoaesthesia, Transient ischaemic attack, Vision blurred

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Truvada 200 mg, Protonix 40 mg, Tylenol 650 mg, ASA 81 mg, Lipitor 10 mg, Omnipaque 350mg, Lisinopril 10 mg, Zofran 4 mg
Current Illness: none
Preexisting Conditions: HTN
Allergies: NKDA NKDA
Diagnostic Lab Data: admitted to hospital TIA
CDC 'Split Type':

Write-up: Patient is a very pleasant 62 year old gentleman with a history of HTN, hyperlipidemia who presented with left facial numbness and left UE numbness. He states that it is worse medially on his arm. Present in upper and lower face. He states it started around 730 am this morning. He also notes intermittent "foggy" sensation since Monday associated with some blurred vision that comes and goes. Denies focal weakness, unsteady gait, difficulty with speech and swallow. He denies f/c, cp, sob, rash, pruritis, n/v/d, edema. He did receive the Pfizer COVID vaccine yesterday

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