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This is VAERS ID 950893

History of Changes from the VAERS Wayback Machine

First Appeared on 1/22/2021

VAERS ID: 950893
VAERS Form:2
Age:90.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-01-03
Onset:2021-01-07
Submitted:0000-00-00
Entered:2021-01-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Senior Living      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-07
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: Ask the nursing home,
Current Illness: Diabetes dementia, cll, trigeminal neuralgia
Preexisting Conditions: Diabetes dementia cll trigeminal neuralgia
Allergies: Shellfish, other
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Death


Changed on 5/7/2021

VAERS ID: 950893 Before After
VAERS Form:2
Age:90.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-01-03
Onset:2021-01-07
Submitted:0000-00-00
Entered:2021-01-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Senior Living      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-07
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: Ask the nursing home,
Current Illness: Diabetes dementia, cll, trigeminal neuralgia
Preexisting Conditions: Diabetes dementia cll trigeminal neuralgia
Allergies: Shellfish, other other
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Death


Changed on 5/14/2021

VAERS ID: 950893 Before After
VAERS Form:2
Age:90.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-01-03
Onset:2021-01-07
Submitted:0000-00-00
Entered:2021-01-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Senior Living      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-07
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: Ask the nursing home,
Current Illness: Diabetes dementia, cll, trigeminal neuralgia
Preexisting Conditions: Diabetes dementia cll trigeminal neuralgia
Allergies: Shellfish, other other
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Death

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=950893&WAYBACKHISTORY=ON

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