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This is VAERS ID 1366132

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1366132
VAERS Form:2
Age:72.0
Sex:Male
Location:Colorado
Vaccinated:2021-05-18
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0182 / 1 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chills, Pyrexia, COVID-19, SARS-CoV-2 test positive

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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: COPD
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 6/1/21 Patient started experiencing fever and chills. Patient tested positive for Covid 19 at doctor''s office/

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1366132&WAYBACKHISTORY=ON


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