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This is VAERS ID 934059

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/22/2021

VAERS ID: 934059
VAERS Form:2
Age:99.0
Sex:Female
Location:Iowa
Vaccinated:2021-01-08
Onset:2021-01-09
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Senior Living      Purchased by: ??
Symptoms: Acute myocardial infarction, Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-10
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: tramadol, calcium, Tylenol, lisinopril, Mucinex, MVI, namenda
Current Illness: Had Covid 19 infection in November recovered, had spinal stenosis with leg weakness chronic
Preexisting Conditions:
Allergies: anastrozole
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Acute anterior MI with death


Changed on 5/7/2021

VAERS ID: 934059 Before After
VAERS Form:2
Age:99.0
Sex:Female
Location:Iowa
Vaccinated:2021-01-08
Onset:2021-01-09
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Senior Living      Purchased by: ??
Symptoms: Acute myocardial infarction, Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-10
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: tramadol, calcium, Tylenol, lisinopril, Mucinex, MVI, namenda
Current Illness: Had Covid 19 infection in November recovered, had spinal stenosis with leg weakness chronic
Preexisting Conditions:
Allergies: anastrozole anastrozole
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Acute anterior MI with death


Changed on 5/21/2021

VAERS ID: 934059 Before After
VAERS Form:2
Age:99.0
Sex:Female
Location:Iowa
Vaccinated:2021-01-08
Onset:2021-01-09
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Senior Living      Purchased by: ??
Symptoms: Acute myocardial infarction, Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-10
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: tramadol, calcium, Tylenol, lisinopril, Mucinex, MVI, namenda
Current Illness: Had Covid 19 infection in November recovered, had spinal stenosis with leg weakness chronic
Preexisting Conditions:
Allergies: anastrozole anastrozole
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Acute anterior MI with death

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