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This is VAERS ID 1775484

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1775484
VAERS Form:2
Age:48.0
Sex:Male
Location:Arizona
Vaccinated:2021-02-28
Onset:2021-10-10
Submitted:0000-00-00
Entered:2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: COVID-19 pneumonia

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: none
Current Illness: none
Preexisting Conditions: obesity, hypertension
Allergies: COCONUTS, APRICOTS
Diagnostic Lab Data: NO ADVERSE EVENTS HOWEVER DIAGNOSED WITH COVID-19 PNEUMONIA 10/10/2021
CDC 'Split Type':

Write-up: NO ADVERSE EVENTS HOWEVER DIAGNOSED WITH COVID-19 PNEUMONIA 10/10/2021

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