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This is VAERS ID 1484484

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1484484
VAERS Form:2
Age:56.0
Sex:Male
Location:Minnesota
Vaccinated:2021-01-12
Onset:2021-07-18
Submitted:0000-00-00
Entered:2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4176 / 2 LA / IM

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? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient tested positive for COVID 7/18/21. He is fully vaccinated.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1484484&WAYBACKHISTORY=ON


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