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This is VAERS ID 1105119

History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1105119
VAERS Form:2
Age:68.0
Sex:Male
Location:California
Vaccinated:2021-02-10
Onset:2021-03-02
Submitted:0000-00-00
Entered:2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / UNK - / -

Administered by: Public      Purchased by: ??
Symptoms: Blindness, Computerised tomogram, Echocardiogram, Retinal artery occlusion, Laboratory test, Magnetic resonance imaging

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Baby aspirin, Vitamins B & D and Omega 3 up to day of vaccine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: MRI, CAT Scan, Echo Cardiogram and numerous lab tests as well as 6 hyperbaric chamber treatments.
CDC 'Split Type':

Write-up: Permanent loss of vision in right eye three weeks after receiving first COVID 19 vaccination. Diagnosed with Branch Retina Artery Occlusion (BRAO) clotting of the retinal artery. Emergency Room admittance and 4 day stay at Hospital at direction of Retina Specialist Dr.


Changed on 5/7/2021

VAERS ID: 1105119 Before After
VAERS Form:2
Age:68.0
Sex:Male
Location:California
Vaccinated:2021-02-10
Onset:2021-03-02
Submitted:0000-00-00
Entered:2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / UNK - / -

Administered by: Public      Purchased by: ??
Symptoms: Blindness, Computerised tomogram, Echocardiogram, Retinal artery occlusion, Laboratory test, Magnetic resonance imaging

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Baby aspirin, Vitamins B & D and Omega 3 up to day of vaccine
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: MRI, CAT Scan, Echo Cardiogram and numerous lab tests as well as 6 hyperbaric chamber treatments.
CDC 'Split Type':

Write-up: Permanent loss of vision in right eye three weeks after receiving first COVID 19 vaccination. Diagnosed with Branch Retina Artery Occlusion (BRAO) clotting of the retinal artery. Emergency Room admittance and 4 day stay at Hospital at direction of Retina Specialist Dr.


Changed on 5/14/2021

VAERS ID: 1105119 Before After
VAERS Form:2
Age:68.0
Sex:Male
Location:California
Vaccinated:2021-02-10
Onset:2021-03-02
Submitted:0000-00-00
Entered:2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / UNK - / -

Administered by: Public      Purchased by: ??
Symptoms: Blindness, Computerised tomogram, Echocardiogram, Retinal artery occlusion, Laboratory test, Magnetic resonance imaging

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Baby aspirin, Vitamins B & D and Omega 3 up to day of vaccine
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: MRI, CAT Scan, Echo Cardiogram and numerous lab tests as well as 6 hyperbaric chamber treatments.
CDC 'Split Type':

Write-up: Permanent loss of vision in right eye three weeks after receiving first COVID 19 vaccination. Diagnosed with Branch Retina Artery Occlusion (BRAO) clotting of the retinal artery. Emergency Room admittance and 4 day stay at Hospital at direction of Retina Specialist Dr.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1105119&WAYBACKHISTORY=ON


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