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This is VAERS ID 1762064

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1762064
VAERS Form:2
Age:56.0
Sex:Male
Location:Wisconsin
Vaccinated:2021-09-16
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 FD0809 / 3 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Condition aggravated, Dizziness, Fatigue, Full blood count, Pain in extremity, Tremor

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Some fatigue, lightheadedness Ankylosing spondylitis- on Humira
Preexisting Conditions: Ankylosing spondylitis
Allergies:
Diagnostic Lab Data: CBC
CDC 'Split Type':

Write-up: Lightheadedness, worsened fatigue, shaky-intermittent, lower extremity achiness-bilateral

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