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This is VAERS ID 1017272

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 1017272
VAERS Form:2
Age:82.0
Sex:Male
Location:California
Vaccinated:2021-01-21
Onset:2021-01-22
Submitted:0000-00-00
Entered:2021-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Myocardial infarction, Pancytopenia, Platelet count decreased, Troponin increased, Blood test abnormal

Life Threatening? Yes
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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Was taking lisinopril asa,
Current Illness: Htn, hyperlipidemia , mi stent , brain aneurysm
Preexisting Conditions: As above
Allergies: Nkda
Diagnostic Lab Data: Platelets 48 Panc less than 500 Elevated troponin Myocardial infarction
CDC 'Split Type':

Write-up: Myocardial infarction Pancytopenia


Changed on 5/7/2021

VAERS ID: 1017272 Before After
VAERS Form:2
Age:82.0
Sex:Male
Location:California
Vaccinated:2021-01-21
Onset:2021-01-22
Submitted:0000-00-00
Entered:2021-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Myocardial infarction, Pancytopenia, Platelet count decreased, Troponin increased, Blood test abnormal

Life Threatening? Yes
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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Was taking lisinopril asa,
Current Illness: Htn, hyperlipidemia , mi stent , brain aneurysm
Preexisting Conditions: As above
Allergies: Nkda Nkda
Diagnostic Lab Data: Platelets 48 Panc less than 500 Elevated troponin Myocardial infarction
CDC 'Split Type':

Write-up: Myocardial infarction Pancytopenia


Changed on 5/21/2021

VAERS ID: 1017272 Before After
VAERS Form:2
Age:82.0
Sex:Male
Location:California
Vaccinated:2021-01-21
Onset:2021-01-22
Submitted:0000-00-00
Entered:2021-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Myocardial infarction, Pancytopenia, Platelet count decreased, Troponin increased, Blood test abnormal

Life Threatening? Yes
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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Was taking lisinopril asa,
Current Illness: Htn, hyperlipidemia , mi stent , brain aneurysm
Preexisting Conditions: As above
Allergies: Nkda Nkda
Diagnostic Lab Data: Platelets 48 Panc less than 500 Elevated troponin Myocardial infarction
CDC 'Split Type':

Write-up: Myocardial infarction Pancytopenia

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