National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1764739

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1764739
VAERS Form:2
Age:65.0
Sex:Male
Location:Minnesota
Vaccinated:2021-04-22
Onset:2021-09-30
Submitted:0000-00-00
Entered:2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNK / 2 UN / UN

Administered by: Private      Purchased by: ??
Symptoms: COVID-19, SARS-CoV-2 test positive

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: Patient swabbed at our offsite testing facility
Current Illness: Patient swabbed at our offsite testing facility
Preexisting Conditions: Patient swabbed at our offsite testing facility
Allergies: Patient swabbed at our offsite testing facility
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient vaccinated and then tested positive for COVID-19

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1764739&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166