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This is VAERS ID 1431381

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1431381
VAERS Form:2
Age:72.0
Sex:Male
Location:Colorado
Vaccinated:2021-01-30
Onset:2021-06-26
Submitted:0000-00-00
Entered:2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private      Purchased by: ??
Symptoms: COVID-19, SARS-CoV-2 test positive

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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Eliquis, Atorvastatin, Doxazosin, Losartan, Pantoprazole, Dexamethasone, Lantus, Cholecalciferol.
Current Illness: Ascending aortic aneurysm w/endovascular stent graft, hyperlipidemia, OSA, PVD, DM2, TIA, GERD, CAD w/stents and CABG, CKD Stage 4, COPD, h/o PE, BPH and L-renal stenosis.
Preexisting Conditions: Ascending aortic aneurysm w/endovascular stent graft, hyperlipidemia, OSA, PVD, DM2, TIA, GERD, CAD w/stents and CABG, CKD Stage 4, COPD, h/o PE, BPH and L-renal stenosis.
Allergies: NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: COVID (+) 6/26/21 -- $g admitted to Medical Center despite being fully vaccinated.

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