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This is VAERS ID 903082

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 903082
VAERS Form:2
Age:66.0
Sex:Male
Location:Missouri
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Cough, Diarrhoea, Dyspnoea, Hyperhidrosis, Myalgia, Mental status changes

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: Yes
Current Illness: none, did have covid by pcr in November, no one asked that question.
Preexisting Conditions: HTN, PTSD, hypercholesterolemia
Allergies: none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Persistant cough, dyspnea, sweats, myalgias, mental staus changes and diarrhea, still resoving


Changed on 12/24/2020

VAERS ID: 903082 Before After
VAERS Form:2
Age:66.0
Sex:Male
Location:Missouri
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Cough, Diarrhoea, Dyspnoea, Hyperhidrosis, Myalgia, Mental status changes

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: Yes
Current Illness: none, did have covid by pcr in November, no one asked that question.
Preexisting Conditions: HTN, PTSD, hypercholesterolemia
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Persistant cough, dyspnea, sweats, myalgias, mental staus changes and diarrhea, still resoving


Changed on 12/30/2020

VAERS ID: 903082 Before After
VAERS Form:2
Age:66.0
Sex:Male
Location:Missouri
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Cough, Diarrhoea, Dyspnoea, Hyperhidrosis, Myalgia, Mental status changes

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: Yes
Current Illness: none, did have covid by pcr in November, no one asked that question.
Preexisting Conditions: HTN, PTSD, hypercholesterolemia
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Persistant cough, dyspnea, sweats, myalgias, mental staus changes and diarrhea, still resoving


Changed on 5/7/2021

VAERS ID: 903082 Before After
VAERS Form:2
Age:66.0
Sex:Male
Location:Missouri
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Cough, Diarrhoea, Dyspnoea, Hyperhidrosis, Myalgia, Mental status changes

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: Yes
Current Illness: none, did have covid by pcr in November, no one asked that question.
Preexisting Conditions: HTN, PTSD, hypercholesterolemia
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Persistant cough, dyspnea, sweats, myalgias, mental staus changes and diarrhea, still resoving


Changed on 5/21/2021

VAERS ID: 903082 Before After
VAERS Form:2
Age:66.0
Sex:Male
Location:Missouri
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Cough, Diarrhoea, Dyspnoea, Hyperhidrosis, Myalgia, Mental status changes

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: Yes
Current Illness: none, did have covid by pcr in November, no one asked that question.
Preexisting Conditions: HTN, PTSD, hypercholesterolemia
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Persistant cough, dyspnea, sweats, myalgias, mental staus changes and diarrhea, still resoving

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