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This is VAERS ID 1240899

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1240899
VAERS Form:2
Age:37.0
Sex:Male
Location:Ohio
Vaccinated:2021-04-17
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Chills, Depression, Rhinorrhoea

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Humalog, Lantus, Zoloft, Rexulti, Vistatil, Truvada
Current Illness:
Preexisting Conditions: Diabetes Type 1.5, Major Depression,
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Runny Nose, Chills, Depression


Changed on 5/7/2021

VAERS ID: 1240899 Before After
VAERS Form:2
Age:37.0
Sex:Male
Location:Ohio
Vaccinated:2021-04-17
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Chills, Depression, Rhinorrhoea

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Humalog, Lantus, Zoloft, Rexulti, Vistatil, Truvada
Current Illness:
Preexisting Conditions: Diabetes Type 1.5, Major Depression,
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Runny Nose, Chills, Depression


Changed on 5/14/2021

VAERS ID: 1240899 Before After
VAERS Form:2
Age:37.0
Sex:Male
Location:Ohio
Vaccinated:2021-04-17
Onset:2021-04-19
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Chills, Depression, Rhinorrhoea

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Humalog, Lantus, Zoloft, Rexulti, Vistatil, Truvada
Current Illness:
Preexisting Conditions: Diabetes Type 1.5, Major Depression,
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Runny Nose, Chills, Depression

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1240899&WAYBACKHISTORY=ON


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