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This is VAERS ID 647289

History of Changes from the VAERS Wayback Machine

First Appeared on 10/14/2016

VAERS ID: 647289
VAERS Form:
Age:74.0
Gender:Male
Location:Vermont
Vaccinated:2016-07-26
Onset:2016-07-26
Submitted:2016-08-11
Entered:2016-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH M79320 / 0 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Chest pain, Chest X-ray, Feeling hot, Malaise, Pain, Pericarditis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zocor, hyzaar, Zoloft, aspirin, fish oil, calcium, glucosamine chondroitin, albuterol, multivitamin
Current Illness: No
Preexisting Conditions: CAD, HTN, arthritis
Allergies:
Diagnostic Lab Data: ER did labs, chest CT. Seen for f/u in doctor''s office. Referral to cardiology.
CDC 'Split Type':

Write-up: Body aches, chest pain, feeling hot, malaise. Diagnosed with pericarditis in ER.


Changed on 9/14/2017

VAERS ID: 647289 Before After
VAERS Form:(blank) 1
Age:74.0
Gender:Male
Location:Vermont
Vaccinated:2016-07-26
Onset:2016-07-26
Submitted:2016-08-11
Entered:2016-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH M79320 / 0 1 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Chest pain, Chest X-ray, Feeling hot, Malaise, Pain, Pericarditis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zocor, hyzaar, Zoloft, aspirin, fish oil, calcium, glucosamine chondroitin, albuterol, multivitamin
Current Illness: No
Preexisting Conditions: CAD, HTN, arthritis
Allergies:
Diagnostic Lab Data: ER did labs, chest CT. Seen for f/u in doctor''s office. Referral to cardiology.
CDC 'Split Type':

Write-up: Body aches, chest pain, feeling hot, malaise. Diagnosed with pericarditis in ER.


Changed on 2/14/2018

VAERS ID: 647289 Before After
VAERS Form:1
Age:74.0
Gender:Male
Location:Vermont
Vaccinated:2016-07-26
Onset:2016-07-26
Submitted:2016-08-11
Entered:2016-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH M79320 / 1 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Chest pain, Chest X-ray, Feeling hot, Malaise, Pain, Pericarditis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zocor, hyzaar, Zoloft, aspirin, fish oil, calcium, glucosamine chondroitin, albuterol, multivitamin
Current Illness: No
Preexisting Conditions: CAD, HTN, arthritis
Allergies:
Diagnostic Lab Data: ER did labs, chest CT. Seen for f/u in doctor''s office. Referral to cardiology.
CDC 'Split Type':

Write-up: Body aches, chest pain, feeling hot, malaise. Diagnosed with pericarditis in ER.


Changed on 6/14/2018

VAERS ID: 647289 Before After
VAERS Form:1
Age:74.0
Gender:Male
Location:Vermont
Vaccinated:2016-07-26
Onset:2016-07-26
Submitted:2016-08-11
Entered:2016-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH M79320 / 1 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Chest pain, Chest X-ray, Feeling hot, Malaise, Pain, Pericarditis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zocor, hyzaar, Zoloft, aspirin, fish oil, calcium, glucosamine chondroitin, albuterol, multivitamin
Current Illness: No
Preexisting Conditions: CAD, HTN, arthritis
Allergies:
Diagnostic Lab Data: ER did labs, chest CT. Seen for f/u in doctor''s office. Referral to cardiology.
CDC 'Split Type':

Write-up: Body aches, chest pain, feeling hot, malaise. Diagnosed with pericarditis in ER.


Changed on 8/14/2018

VAERS ID: 647289 Before After
VAERS Form:1
Age:74.0
Gender:Male
Location:Vermont
Vaccinated:2016-07-26
Onset:2016-07-26
Submitted:2016-08-11
Entered:2016-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH M79320 / 1 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Chest pain, Chest X-ray, Feeling hot, Malaise, Pain, Pericarditis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zocor, hyzaar, Zoloft, aspirin, fish oil, calcium, glucosamine chondroitin, albuterol, multivitamin
Current Illness: No
Preexisting Conditions: CAD, HTN, arthritis
Allergies:
Diagnostic Lab Data: ER did labs, chest CT. Seen for f/u in doctor''s office. Referral to cardiology.
CDC 'Split Type':

Write-up: Body aches, chest pain, feeling hot, malaise. Diagnosed with pericarditis in ER.


Changed on 9/14/2018

VAERS ID: 647289 Before After
VAERS Form:1
Age:74.0
Gender:Male
Location:Vermont
Vaccinated:2016-07-26
Onset:2016-07-26
Submitted:2016-08-11
Entered:2016-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH M79320 / 1 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Chest pain, Chest X-ray, Feeling hot, Malaise, Pain, Pericarditis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zocor, hyzaar, Zoloft, aspirin, fish oil, calcium, glucosamine chondroitin, albuterol, multivitamin
Current Illness: No
Preexisting Conditions: CAD, HTN, arthritis
Allergies:
Diagnostic Lab Data: ER did labs, chest CT. Seen for f/u in doctor''s office. Referral to cardiology.
CDC 'Split Type':

Write-up: Body aches, chest pain, feeling hot, malaise. Diagnosed with pericarditis in ER.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=647289&WAYBACKHISTORY=ON


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