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This is VAERS ID 1753332

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1753332
VAERS Form:2
Age:91.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-09-29
Onset:2021-09-30
Submitted:0000-00-00
Entered:2021-10-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 AR / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Pyrexia

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: Fever began on 9/30/2021 at 0426 of 99.4. Throughout the day of 9/30/2021 continually increased to 103.0 at 2120. Given tylenol and fever has subsided. 10/1/2021 at 0823 98.1.

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