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This is VAERS ID 1761536

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1761536
VAERS Form:2
Age:78.0
Sex:Female
Location:Michigan
Vaccinated:2021-04-08
Onset:2021-09-30
Submitted:0000-00-00
Entered:2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207, EW0158 / 2 UN / UN

Administered by: Unknown      Purchased by: ??
Symptoms: Asthenia, Cough, Dyspnoea, Myalgia, Pyrexia, Vomiting, Fluid intake reduced, Decreased appetite

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: Unknown
Current Illness: Unknown
Preexisting Conditions: Hypertension, DVT/PEs
Allergies: Penicillin, tetanus immune globulin
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: unable to eat or drink much or take medications, too weak to do anything, vomiting, fevers, myalgias, cough and SOB.

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