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This is VAERS ID 1731449

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/1/2021

VAERS ID: 1731449
VAERS Form:2
Age:77.0
Sex:Male
Location:Unknown
Vaccinated:2021-01-21
Onset:2021-09-12
Submitted:0000-00-00
Entered:2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Malaise, Vaccine breakthrough infection

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

Write-up: Vaccine breakthrough, symptomatic. 9/12 Inpatient admit 9/17 to present,

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