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This is VAERS ID 904258

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 904258
VAERS Form:2
Age:42.0
Sex:Male
Location:California
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Disturbance in attention, Dizziness, Fatigue, Flushing, Hyperhidrosis, Memory impairment, Petechiae, Rash, Rash erythematous, Rash pruritic

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

Write-up: 1) flushing, sweats, and dizziness 2 hours after dose #1. Resolved after about 15 minutes. 2) severe fatigue next day with poor concentration and forgetfulness 3) whole body palpable rash with redness, itching, and development of patches of petechiae


Changed on 12/30/2020

VAERS ID: 904258 Before After
VAERS Form:2
Age:42.0
Sex:Male
Location:California
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Disturbance in attention, Dizziness, Fatigue, Flushing, Hyperhidrosis, Memory impairment, Petechiae, Rash, Rash erythematous, Rash pruritic

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

Write-up: 1) flushing, sweats, and dizziness 2 hours after dose #1. Resolved after about 15 minutes. 2) severe fatigue next day with poor concentration and forgetfulness 3) whole body palpable rash with redness, itching, and development of patches of petechiae


Changed on 5/7/2021

VAERS ID: 904258 Before After
VAERS Form:2
Age:42.0
Sex:Male
Location:California
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Disturbance in attention, Dizziness, Fatigue, Flushing, Hyperhidrosis, Memory impairment, Petechiae, Rash, Rash erythematous, Rash pruritic

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

Write-up: 1) flushing, sweats, and dizziness 2 hours after dose #1. Resolved after about 15 minutes. 2) severe fatigue next day with poor concentration and forgetfulness 3) whole body palpable rash with redness, itching, and development of patches of petechiae


Changed on 5/14/2021

VAERS ID: 904258 Before After
VAERS Form:2
Age:42.0
Sex:Male
Location:California
Vaccinated:2020-12-17
Onset:2020-12-17
Submitted:0000-00-00
Entered:2020-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Disturbance in attention, Dizziness, Fatigue, Flushing, Hyperhidrosis, Memory impairment, Petechiae, Rash, Rash erythematous, Rash pruritic

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

Write-up: 1) flushing, sweats, and dizziness 2 hours after dose #1. Resolved after about 15 minutes. 2) severe fatigue next day with poor concentration and forgetfulness 3) whole body palpable rash with redness, itching, and development of patches of petechiae

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