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This is VAERS ID 905345

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 905345
VAERS Form:2
Age:22.0
Sex:Male
Location:Wisconsin
Vaccinated:2020-12-17
Onset:2020-12-20
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Platelet count decreased, Haemorrhage, SARS-CoV-2 test negative

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)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None reported by patient
Current Illness: No known past medical history
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: COVID (-) Platelets 2000 cells/mcL
CDC 'Split Type':

Write-up: Patient received Pfizer COVID 19 vaccine last Thursday 12/17. Admitted today (12/21) with bleeding and low platelet count - working up for ITP, TTP. Given recency of vaccination and no known contributory allergy or medical history, physician thought potentially associated with vaccination.


Changed on 12/30/2020

VAERS ID: 905345 Before After
VAERS Form:2
Age:22.0
Sex:Male
Location:Wisconsin
Vaccinated:2020-12-17
Onset:2020-12-20
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Platelet count decreased, Haemorrhage, SARS-CoV-2 test negative

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)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None reported by patient
Current Illness: No known past medical history
Preexisting Conditions: None
Allergies: No known allergies allergies
Diagnostic Lab Data: COVID (-) Platelets 2000 cells/mcL
CDC 'Split Type':

Write-up: Patient received Pfizer COVID 19 vaccine last Thursday 12/17. Admitted today (12/21) with bleeding and low platelet count - working up for ITP, TTP. Given recency of vaccination and no known contributory allergy or medical history, physician thought potentially associated with vaccination.


Changed on 1/22/2021

VAERS ID: 905345 Before After
VAERS Form:2
Age:22.0
Sex:Male
Location:Wisconsin
Vaccinated:2020-12-17
Onset:2020-12-20
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Platelet count decreased, Thrombocytopenia, Haemorrhage, SARS-CoV-2 test negative

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)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None reported by patient
Current Illness: No known past medical history
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: COVID (-) Platelets 2000 cells/mcL
CDC 'Split Type':

Write-up: Patient received Pfizer COVID 19 vaccine last Thursday 12/17. Admitted today (12/21) with bleeding and low platelet count - working up for ITP, TTP. Given recency of vaccination and no known contributory allergy or medical history, physician thought potentially associated with vaccination.


Changed on 5/7/2021

VAERS ID: 905345 Before After
VAERS Form:2
Age:22.0
Sex:Male
Location:Wisconsin
Vaccinated:2020-12-17
Onset:2020-12-20
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Platelet count decreased, Thrombocytopenia, Haemorrhage, SARS-CoV-2 test negative

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)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None reported by patient
Current Illness: No known past medical history
Preexisting Conditions: None
Allergies: No known allergies allergies
Diagnostic Lab Data: COVID (-) Platelets 2000 cells/mcL
CDC 'Split Type':

Write-up: Patient received Pfizer COVID 19 vaccine last Thursday 12/17. Admitted today (12/21) with bleeding and low platelet count - working up for ITP, TTP. Given recency of vaccination and no known contributory allergy or medical history, physician thought potentially associated with vaccination.


Changed on 5/14/2021

VAERS ID: 905345 Before After
VAERS Form:2
Age:22.0
Sex:Male
Location:Wisconsin
Vaccinated:2020-12-17
Onset:2020-12-20
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Platelet count decreased, Thrombocytopenia, Haemorrhage, SARS-CoV-2 test negative

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)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None reported by patient
Current Illness: No known past medical history
Preexisting Conditions: None
Allergies: No known allergies allergies
Diagnostic Lab Data: COVID (-) Platelets 2000 cells/mcL
CDC 'Split Type':

Write-up: Patient received Pfizer COVID 19 vaccine last Thursday 12/17. Admitted today (12/21) with bleeding and low platelet count - working up for ITP, TTP. Given recency of vaccination and no known contributory allergy or medical history, physician thought potentially associated with vaccination.

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