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This is VAERS ID 936139

History of Changes from the VAERS Wayback Machine

First Appeared on 3/26/2021

VAERS ID: 936139
VAERS Form:2
Age:50.0
Sex:Male
Location:Michigan
Vaccinated:2020-12-23
Onset:2020-12-28
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Prothrombin time prolonged, Purpura, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: omeprazole, Fish oil, multi vitamin and Vit D
Current Illness: elevated cholesterol levels and GERD
Preexisting Conditions: Possible hypercholesterolemia
Allergies: NKDA
Diagnostic Lab Data: PT 13.3
CDC 'Split Type':

Write-up: purpura rash on bi-lat feet, ankles and legs. Elevated PT


Changed on 5/7/2021

VAERS ID: 936139 Before After
VAERS Form:2
Age:50.0
Sex:Male
Location:Michigan
Vaccinated:2020-12-23
Onset:2020-12-28
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Prothrombin time prolonged, Purpura, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: omeprazole, Fish oil, multi vitamin and Vit D
Current Illness: elevated cholesterol levels and GERD
Preexisting Conditions: Possible hypercholesterolemia
Allergies: NKDA NKDA
Diagnostic Lab Data: PT 13.3
CDC 'Split Type':

Write-up: purpura rash on bi-lat feet, ankles and legs. Elevated PT


Changed on 5/14/2021

VAERS ID: 936139 Before After
VAERS Form:2
Age:50.0
Sex:Male
Location:Michigan
Vaccinated:2020-12-23
Onset:2020-12-28
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Prothrombin time prolonged, Purpura, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: omeprazole, Fish oil, multi vitamin and Vit D
Current Illness: elevated cholesterol levels and GERD
Preexisting Conditions: Possible hypercholesterolemia
Allergies: NKDA NKDA
Diagnostic Lab Data: PT 13.3
CDC 'Split Type':

Write-up: purpura rash on bi-lat feet, ankles and legs. Elevated PT

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=936139&WAYBACKHISTORY=ON

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