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This is VAERS ID 1656201

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/3/2021

VAERS ID: 1656201
VAERS Form:2
Age:79.0
Sex:Male
Location:Unknown
Vaccinated:2021-02-11
Onset:2021-08-26
Submitted:0000-00-00
Entered:2021-08-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Unevaluable event

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CLL
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Hospital 8/26/21

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1656201&WAYBACKHISTORY=ON


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