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This is VAERS ID 1402036

History of Changes from the VAERS Wayback Machine

First Appeared on 6/18/2021

VAERS ID: 1402036
VAERS Form:2
Age:62.0
Sex:Male
Location:Pennsylvania
Vaccinated:2021-03-27
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Bronchitis, Cough, Nasal congestion, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: albuterol sulfate (PROAIR RESPICLICK) 90 mcg/actuation aerosol powdr breath activated allopurinoL (ZYLOPRIM) 100 mg tablet aspirin (ASPIRIN LOW DOSE) 81 mg tablet esomeprazole (NexIUM) 40 mg capsule(Expired) famotidine (PEPCID) 20 mg tablet
Current Illness: None
Preexisting Conditions: Nervous Cervical radiculopathy, chronic Neuropathy Exertional chest pain Respiratory Asthma, intermittent Chronic cough Pulmonary nodule Digestive Irritable bowel syndrome Musculoskeletal Generalized osteoarthritis of multiple sites DDD (degenerative disc disease), cervical Endocrine/Metabolic Gout Other Cervical stenosis of spine Pre-procedural cardiovascular examination
Allergies: No Known Allergies
Diagnostic Lab Data: COVID-19 PCR
CDC 'Split Type':

Write-up: Acute bronchitis cough Nasal Congestion - predniSONE (DELTASONE) 20 mg tablet; Take 2 tablets (40 mg total) by mouth daily for 5 days - azithromycin (ZITHROMAX) 250 mg tablet; Take 2 tabs (500 mg) by mouth today, than 1 daily for 4 days. - amoxicillin-pot clavulanate (AUGMENTIN) 875-125 mg per tablet; Take 1 tablet by mouth 2 (two) times a day for 10 days

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1402036&WAYBACKHISTORY=ON


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