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This is VAERS ID 905774

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 905774
VAERS Form:2
Age:57.0
Sex:Male
Location:Indiana
Vaccinated:2020-12-18
Onset:2020-12-19
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Myocardial infarction

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse reports that patient had no problems after receiving vaccination. Patient went home and EMS was called early the next morning and team administered vaccination was contacted physician that the associate works for stating the patient had a heart attack.


Changed on 12/30/2020

VAERS ID: 905774 Before After
VAERS Form:2
Age:57.0
Sex:Male
Location:Indiana
Vaccinated:2020-12-18
Onset:2020-12-19
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Myocardial infarction

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse reports that patient had no problems after receiving vaccination. Patient went home and EMS was called early the next morning and team administered vaccination was contacted physician that the associate works for stating the patient had a heart attack.


Changed on 5/7/2021

VAERS ID: 905774 Before After
VAERS Form:2
Age:57.0
Sex:Male
Location:Indiana
Vaccinated:2020-12-18
Onset:2020-12-19
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Myocardial infarction

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse reports that patient had no problems after receiving vaccination. Patient went home and EMS was called early the next morning and team administered vaccination was contacted physician that the associate works for stating the patient had a heart attack.


Changed on 5/14/2021

VAERS ID: 905774 Before After
VAERS Form:2
Age:57.0
Sex:Male
Location:Indiana
Vaccinated:2020-12-18
Onset:2020-12-19
Submitted:0000-00-00
Entered:2020-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Myocardial infarction

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Nurse reports that patient had no problems after receiving vaccination. Patient went home and EMS was called early the next morning and team administered vaccination was contacted physician that the associate works for stating the patient had a heart attack.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=905774&WAYBACKHISTORY=ON


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