National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 903820

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 903820
VAERS Form:2
Age:85.0
Sex:Male
Location:Florida
Vaccinated:2020-12-17
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Dyspnoea, Pyrexia, Laboratory test, SARS-CoV-2 test positive

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: eye drops, hydroxyzine, Ivermectin, Xarelto, donepezil, finasteride, melatonin, Tamsulosin, atorvastatin, fluxetine
Current Illness: None
Preexisting Conditions: Dementia, anxiety, glaucoma, hyperlipidemia, COPD
Allergies: Morphine
Diagnostic Lab Data: tests performed at hospital
CDC 'Split Type':

Write-up: Day following vaccine, fever, sob - went to hospital, COVID+


Changed on 12/30/2020

VAERS ID: 903820 Before After
VAERS Form:2
Age:85.0
Sex:Male
Location:Florida
Vaccinated:2020-12-17
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Dyspnoea, Pyrexia, Laboratory test, SARS-CoV-2 test positive

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: eye drops, hydroxyzine, Ivermectin, Xarelto, donepezil, finasteride, melatonin, Tamsulosin, atorvastatin, fluxetine
Current Illness: None
Preexisting Conditions: Dementia, anxiety, glaucoma, hyperlipidemia, COPD
Allergies: Morphine Morphine
Diagnostic Lab Data: tests performed at hospital
CDC 'Split Type':

Write-up: Day following vaccine, fever, sob - went to hospital, COVID+


Changed on 5/7/2021

VAERS ID: 903820 Before After
VAERS Form:2
Age:85.0
Sex:Male
Location:Florida
Vaccinated:2020-12-17
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Dyspnoea, Pyrexia, Laboratory test, SARS-CoV-2 test positive

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: eye drops, hydroxyzine, Ivermectin, Xarelto, donepezil, finasteride, melatonin, Tamsulosin, atorvastatin, fluxetine
Current Illness: None
Preexisting Conditions: Dementia, anxiety, glaucoma, hyperlipidemia, COPD
Allergies: Morphine Morphine
Diagnostic Lab Data: tests performed at hospital
CDC 'Split Type':

Write-up: Day following vaccine, fever, sob - went to hospital, COVID+


Changed on 5/14/2021

VAERS ID: 903820 Before After
VAERS Form:2
Age:85.0
Sex:Male
Location:Florida
Vaccinated:2020-12-17
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Dyspnoea, Pyrexia, Laboratory test, SARS-CoV-2 test positive

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: eye drops, hydroxyzine, Ivermectin, Xarelto, donepezil, finasteride, melatonin, Tamsulosin, atorvastatin, fluxetine
Current Illness: None
Preexisting Conditions: Dementia, anxiety, glaucoma, hyperlipidemia, COPD
Allergies: Morphine Morphine
Diagnostic Lab Data: tests performed at hospital
CDC 'Split Type':

Write-up: Day following vaccine, fever, sob - went to hospital, COVID+

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=903820&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166