National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 1223630

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1223630
VAERS Form:2
Age:60.0
Sex:Female
Location:California
Vaccinated:2021-04-09
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Anxiety, Nausea, Vomiting, Autopsy

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-04-11
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? No
Previous Vaccinations:
Other Medications: Hydrochlorothiazide
Current Illness: Hypertension
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: Coroners report and autopsy pending
CDC 'Split Type':

Write-up: Nausea vomiting throughout the day and continuous the next night, sense on impending doom


Changed on 5/7/2021

VAERS ID: 1223630 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:California
Vaccinated:2021-04-09
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Anxiety, Nausea, Vomiting, Autopsy

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-04-11
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? No
Previous Vaccinations:
Other Medications: Hydrochlorothiazide
Current Illness: Hypertension
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: Coroners report and autopsy pending
CDC 'Split Type':

Write-up: Nausea vomiting throughout the day and continuous the next night, sense on impending doom


Changed on 5/21/2021

VAERS ID: 1223630 Before After
VAERS Form:2
Age:60.0
Sex:Female
Location:California
Vaccinated:2021-04-09
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Anxiety, Nausea, Vomiting, Autopsy

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-04-11
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? No
Previous Vaccinations:
Other Medications: Hydrochlorothiazide
Current Illness: Hypertension
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: Coroners report and autopsy pending
CDC 'Split Type':

Write-up: Nausea vomiting throughout the day and continuous the next night, sense on impending doom

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=1223630&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166