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This is VAERS ID 946959

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/22/2021

VAERS ID: 946959
VAERS Form:2
Age:83.0
Sex:Male
Location:North Carolina
Vaccinated:2021-01-14
Onset:2021-01-15
Submitted:0000-00-00
Entered:2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Sudden death, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-15
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:
Current Illness: Post COVID-19 complications, A-fib, CHF
Preexisting Conditions: Diabetes,
Allergies: None
Diagnostic Lab Data: Unsure, autopsy pending
CDC 'Split Type':

Write-up: Sudden death 18 hours post vaccine .


Changed on 5/7/2021

VAERS ID: 946959 Before After
VAERS Form:2
Age:83.0
Sex:Male
Location:North Carolina
Vaccinated:2021-01-14
Onset:2021-01-15
Submitted:0000-00-00
Entered:2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Sudden death, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-15
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:
Current Illness: Post COVID-19 complications, A-fib, CHF
Preexisting Conditions: Diabetes,
Allergies: None None
Diagnostic Lab Data: Unsure, autopsy pending
CDC 'Split Type':

Write-up: Sudden death 18 hours post vaccine .


Changed on 5/14/2021

VAERS ID: 946959 Before After
VAERS Form:2
Age:83.0
Sex:Male
Location:North Carolina
Vaccinated:2021-01-14
Onset:2021-01-15
Submitted:0000-00-00
Entered:2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Sudden death, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-15
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:
Current Illness: Post COVID-19 complications, A-fib, CHF
Preexisting Conditions: Diabetes,
Allergies: None None
Diagnostic Lab Data: Unsure, autopsy pending
CDC 'Split Type':

Write-up: Sudden death 18 hours post vaccine .

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