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This is VAERS ID 1375801

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1375801
VAERS Form:2
Age:14.0
Sex:Male
Location:Georgia
Vaccinated:2021-05-18
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Activated partial thromboplastin time, Blood urine, Full blood count, Prothrombin time, Ultrasound kidney, Urine analysis, Complement factor C3, Complement factor C4, Metabolic function test, Streptococcus 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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: sertraline
Current Illness: otitis media, cold
Preexisting Conditions: anxiety, asthma
Allergies: none
Diagnostic Lab Data: cbc, cmp, pt, ptt, c3, c4, aso titer, Ua, microscopic urine, renal ultrasound
CDC 'Split Type':

Write-up: blood in the urine

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1375801&WAYBACKHISTORY=ON


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