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This is VAERS ID 1463409

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1463409
VAERS Form:2
Age:62.0
Sex:Male
Location:Utah
Vaccinated:2021-04-15
Onset:2021-07-02
Submitted:0000-00-00
Entered:2021-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Pulmonary embolism, Computerised tomogram thorax

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin, Cetirizine, Chlorthalidone, Genvoya, MVI, D3,
Current Illness: Well controlled HIV, HLD, HTN
Preexisting Conditions: Well controlled HIV, HLD, HTN
Allergies: Amoxicillin
Diagnostic Lab Data: CTA Chest 7/10/2021
CDC 'Split Type':

Write-up: Saddle PE diagnosed 7/10/21

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1463409&WAYBACKHISTORY=ON


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