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This is VAERS ID 1008450

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 1008450
VAERS Form:2
Age:41.0
Sex:Male
Location:Missouri
Vaccinated:2021-01-12
Onset:2021-01-12
Submitted:0000-00-00
Entered:2021-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Full blood count, Gait disturbance, International normalised ratio, Pain, Prothrombin time, Swelling, Ultrasound scan, Deep vein thrombosis, Metabolic function test, Computerised tomogram pelvis, Computerised tomogram spine

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT pelvis/back 01/29/21, ultrasound left leg 01/29/21, CBC, cmp on 1/29/21 and 1/30/21. Pt/inr on 1/29 and 1/30.
CDC 'Split Type':

Write-up: Developed DVT in left leg from groin to ankle. Diagnosed on 01/29/2021. Pain, swelling, and difficulty walking lead to emergency room visit, admission to hospital for 2 days.


Changed on 5/7/2021

VAERS ID: 1008450 Before After
VAERS Form:2
Age:41.0
Sex:Male
Location:Missouri
Vaccinated:2021-01-12
Onset:2021-01-12
Submitted:0000-00-00
Entered:2021-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Full blood count, Gait disturbance, International normalised ratio, Pain, Prothrombin time, Swelling, Ultrasound scan, Deep vein thrombosis, Metabolic function test, Computerised tomogram pelvis, Computerised tomogram spine

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: CT pelvis/back 01/29/21, ultrasound left leg 01/29/21, CBC, cmp on 1/29/21 and 1/30/21. Pt/inr on 1/29 and 1/30.
CDC 'Split Type':

Write-up: Developed DVT in left leg from groin to ankle. Diagnosed on 01/29/2021. Pain, swelling, and difficulty walking lead to emergency room visit, admission to hospital for 2 days.


Changed on 5/21/2021

VAERS ID: 1008450 Before After
VAERS Form:2
Age:41.0
Sex:Male
Location:Missouri
Vaccinated:2021-01-12
Onset:2021-01-12
Submitted:0000-00-00
Entered:2021-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Full blood count, Gait disturbance, International normalised ratio, Pain, Prothrombin time, Swelling, Ultrasound scan, Deep vein thrombosis, Metabolic function test, Computerised tomogram pelvis, Computerised tomogram spine

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: CT pelvis/back 01/29/21, ultrasound left leg 01/29/21, CBC, cmp on 1/29/21 and 1/30/21. Pt/inr on 1/29 and 1/30.
CDC 'Split Type':

Write-up: Developed DVT in left leg from groin to ankle. Diagnosed on 01/29/2021. Pain, swelling, and difficulty walking lead to emergency room visit, admission to hospital for 2 days.

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