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This is VAERS ID 1437843

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1437843
VAERS Form:2
Age:24.0
Sex:Male
Location:Wisconsin
Vaccinated:2021-04-20
Onset:2021-06-29
Submitted:0000-00-00
Entered:2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Blood lactate dehydrogenase normal, C-reactive protein increased, Chest X-ray normal, Cough, Fibrin D dimer normal, Nasopharyngitis, Red blood cell sedimentation rate normal, 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? No
Previous Vaccinations:
Other Medications: Insulin glargine, linsulin lispro
Current Illness:
Preexisting Conditions: Type 1 diabetes
Allergies: No known allergies
Diagnostic Lab Data: 6/29/2021, Normal chest Xray, normal ESR, D-Dimer, and LDH. Mild elevation in CRP.
CDC 'Split Type':

Write-up: Pt received both doses of the Pfizer COVID-19 vaccine, on 3/31/21 and 4/20/21. He then presented to the ER on 6/29/2021 for an unrelated reason (DKA) and was tested per protocol for COVID-19 prior to admission. This test on 6/29/2021 was positive. Pt reports having a mild cold about a week ago, with a mild cough on presentation to the ER. EMR also indicates that he had COVID 12/2020 (fatigue, loss of taste, cough).

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