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This is VAERS ID 1438019

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1438019
VAERS Form:2
Age:70.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-03-01
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 EN6202 / 2 - / SYR

Administered by: Unknown      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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Coronavirus COVID-19~Coronavirus COVID-19 - 06/29/2021 Coronavirus COVID-19~Coronavirus COVID-19 - 06/30/2021
CDC 'Split Type':

Write-up: 11/09/2020 - Tested positive for COVID-19 02/08/2021 & 03/01/2021 - Received Pfizer COVID-19 vaccines 06/29/2021 - Tested positive for COVID-19 at Hospital 06/29/2021 - Admitted to Medical Center / Hospital 06/30/2021 - Tested negative for COVID-19 at Medical Center / Hospital 06/30/2021 - Discharged from Medical Center / Hospital

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