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This is VAERS ID 1775826

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1775826
VAERS Form:2
Age:28.0
Sex:Male
Location:Florida
Vaccinated:2021-10-09
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 - / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chills, Migraine, Pain, Pain in extremity, Pyrexia, Tremor

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: Cholesteatoma
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Pain in arm since 30 minutes after shot At 11:30 AM- (15 hours post shot), feverish, on/off aches At 9:30 PM- 25 hours later- chills shakes, migraine

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