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This is VAERS ID 1109460

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1109460
VAERS Form:2
Age:37.0
Sex:Male
Location:New Hampshire
Vaccinated:2021-03-12
Onset:2021-03-15
Submitted:0000-00-00
Entered:2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Headache, Myocarditis, Troponin increased, Laboratory test

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: depo Testosterone straterra biagra
Current Illness: none
Preexisting Conditions: Myocarditis x 2 Ptsd TBI Hypo gonadism
Allergies: none
Diagnostic Lab Data: Cardiac labs
CDC 'Split Type':

Write-up: Headache Five days Elevated Troponin Myocarditis


Changed on 5/7/2021

VAERS ID: 1109460 Before After
VAERS Form:2
Age:37.0
Sex:Male
Location:New Hampshire
Vaccinated:2021-03-12
Onset:2021-03-15
Submitted:0000-00-00
Entered:2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Headache, Myocarditis, Troponin increased, Laboratory test

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: depo Testosterone straterra biagra
Current Illness: none
Preexisting Conditions: Myocarditis x 2 Ptsd TBI Hypo gonadism
Allergies: none none
Diagnostic Lab Data: Cardiac labs
CDC 'Split Type':

Write-up: Headache Five days Elevated Troponin Myocarditis


Changed on 5/14/2021

VAERS ID: 1109460 Before After
VAERS Form:2
Age:37.0
Sex:Male
Location:New Hampshire
Vaccinated:2021-03-12
Onset:2021-03-15
Submitted:0000-00-00
Entered:2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Headache, Myocarditis, Troponin increased, Laboratory test

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: depo Testosterone straterra biagra
Current Illness: none
Preexisting Conditions: Myocarditis x 2 Ptsd TBI Hypo gonadism
Allergies: none none
Diagnostic Lab Data: Cardiac labs
CDC 'Split Type':

Write-up: Headache Five days Elevated Troponin Myocarditis

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