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This is VAERS ID 1775612

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1775612
VAERS Form:2
Age:73.0
Sex:Male
Location:Texas
Vaccinated:2021-10-04
Onset:2021-10-04
Submitted:0000-00-00
Entered:2021-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30145BA / 3 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Fatigue, Injection site pain, Pain, Pyrexia, Restlessness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Zoloft 25mg; Flomax 0.4mg; Lipitor 10mg; Lipo Flavonoid;
Current Illness: None
Preexisting Conditions: High Cholesterol; Benign Prostate Hyperplasia
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Day of (MON) - soreness at injection site, achy in the evening. NIGHT OF - "Whole body Restlessness" - kept waking up having to move my body, like Restless Legs only including the torso. Day after (TUE) - soreness at injection site, 100 degree fever, fatigue. Spent most of the day in bed. 2nd day after (WED) - soreness at injection site, some fatigue. 3rd day after (THU) - mild fatigue Never had the "Whole body Restlessness" again.

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