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This is VAERS ID 1006641

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 1006641
VAERS Form:2
Age:90.0
Sex:Male
Location:Iowa
Vaccinated:2021-01-30
Onset:2021-01-31
Submitted:0000-00-00
Entered:2021-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Myocardial infarction

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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylonal Extra Strengh Meletona Trazodone Priolsek Phyntanl Patch Laxex Atenolol Alophurinoyl Asa Synthroid Zolofot Tamsulosin
Current Illness: none
Preexisting Conditions: CHF Afib Hypo thirodism HTN Nepolasm of Prostate.
Allergies: none
Diagnostic Lab Data: unknown
CDC 'Split Type':

Write-up: Had Heart Attack like symptoms - sent to Hospital


Changed on 5/7/2021

VAERS ID: 1006641 Before After
VAERS Form:2
Age:90.0
Sex:Male
Location:Iowa
Vaccinated:2021-01-30
Onset:2021-01-31
Submitted:0000-00-00
Entered:2021-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Myocardial infarction

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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylonal Extra Strengh Meletona Trazodone Priolsek Phyntanl Patch Laxex Atenolol Alophurinoyl Asa Synthroid Zolofot Tamsulosin
Current Illness: none
Preexisting Conditions: CHF Afib Hypo thirodism HTN Nepolasm of Prostate.
Allergies: none none
Diagnostic Lab Data: unknown
CDC 'Split Type':

Write-up: Had Heart Attack like symptoms - sent to Hospital


Changed on 5/21/2021

VAERS ID: 1006641 Before After
VAERS Form:2
Age:90.0
Sex:Male
Location:Iowa
Vaccinated:2021-01-30
Onset:2021-01-31
Submitted:0000-00-00
Entered:2021-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 2 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Myocardial infarction

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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylonal Extra Strengh Meletona Trazodone Priolsek Phyntanl Patch Laxex Atenolol Alophurinoyl Asa Synthroid Zolofot Tamsulosin
Current Illness: none
Preexisting Conditions: CHF Afib Hypo thirodism HTN Nepolasm of Prostate.
Allergies: none none
Diagnostic Lab Data: unknown
CDC 'Split Type':

Write-up: Had Heart Attack like symptoms - sent to Hospital

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