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This is VAERS ID 1193443

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1193443
VAERS Form:2
Age:40.0
Sex:Male
Location:Tennessee
Vaccinated:2021-03-25
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Chest pain, Chills, Diarrhoea, Dizziness, Dyspnoea, Echocardiogram, Electrocardiogram, Fatigue, Headache, Myocarditis, Pericarditis, Pyrexia, Blood test, Bacterial test negative

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Blood work was taken twice a day starting Sunday, March 29th until Wednesday, March 31st. EKG test were ran during that same time span and Echocardiogram were ran during that time span. I was tested for auto immune diseases and they all came back negative. I was tested for virus and bacteria all came back negative. I was diagnosed with Myocarditis and Pericarditis.
CDC 'Split Type':

Write-up: Thursday, March 25th at 3:10pm I received my 2nd dose of the Pfizer vaccine. Thursday, March 25th at 9pm I had cold chills, headache, low grade fever, diarrhea, and fatigue. These symptoms lasted Thursday night, Friday, Saturday (March 25th - March 28th). Sunday, March 29th at 4am I woke up with severe chest pains, shortness of breath and light headed. At this time I went to the emergency room.


Changed on 5/7/2021

VAERS ID: 1193443 Before After
VAERS Form:2
Age:40.0
Sex:Male
Location:Tennessee
Vaccinated:2021-03-25
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Chest pain, Chills, Diarrhoea, Dizziness, Dyspnoea, Echocardiogram, Electrocardiogram, Fatigue, Headache, Myocarditis, Pericarditis, Pyrexia, Blood test, Bacterial test negative

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: Blood work was taken twice a day starting Sunday, March 29th until Wednesday, March 31st. EKG test were ran during that same time span and Echocardiogram were ran during that time span. I was tested for auto immune diseases and they all came back negative. I was tested for virus and bacteria all came back negative. I was diagnosed with Myocarditis and Pericarditis.
CDC 'Split Type':

Write-up: Thursday, March 25th at 3:10pm I received my 2nd dose of the Pfizer vaccine. Thursday, March 25th at 9pm I had cold chills, headache, low grade fever, diarrhea, and fatigue. These symptoms lasted Thursday night, Friday, Saturday (March 25th - March 28th). Sunday, March 29th at 4am I woke up with severe chest pains, shortness of breath and light headed. At this time I went to the emergency room.


Changed on 5/14/2021

VAERS ID: 1193443 Before After
VAERS Form:2
Age:40.0
Sex:Male
Location:Tennessee
Vaccinated:2021-03-25
Onset:2021-03-25
Submitted:0000-00-00
Entered:2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Chest pain, Chills, Diarrhoea, Dizziness, Dyspnoea, Echocardiogram, Electrocardiogram, Fatigue, Headache, Myocarditis, Pericarditis, Pyrexia, Blood test, Bacterial test negative

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: Blood work was taken twice a day starting Sunday, March 29th until Wednesday, March 31st. EKG test were ran during that same time span and Echocardiogram were ran during that time span. I was tested for auto immune diseases and they all came back negative. I was tested for virus and bacteria all came back negative. I was diagnosed with Myocarditis and Pericarditis.
CDC 'Split Type':

Write-up: Thursday, March 25th at 3:10pm I received my 2nd dose of the Pfizer vaccine. Thursday, March 25th at 9pm I had cold chills, headache, low grade fever, diarrhea, and fatigue. These symptoms lasted Thursday night, Friday, Saturday (March 25th - March 28th). Sunday, March 29th at 4am I woke up with severe chest pains, shortness of breath and light headed. At this time I went to the emergency room.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1193443&WAYBACKHISTORY=ON

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