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This is VAERS ID 972836

History of Changes from the VAERS Wayback Machine

First Appeared on 1/29/2021

VAERS ID: 972836
VAERS Form:2
Age:88.0
Sex:Female
Location:Massachusetts
Vaccinated:2021-01-20
Onset:2021-01-24
Submitted:0000-00-00
Entered:2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / UN

Administered by: Senior Living      Purchased by: ??
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-24
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: lorazepam, trazodone, levothyroxine , acetaminophen, multivitamin, senna
Current Illness: no
Preexisting Conditions: Alzheimer''s disease
Allergies: Levofloxacin, ACE inhibitors
Diagnostic Lab Data: no
CDC 'Split Type':

Write-up: sudden death


Changed on 5/7/2021

VAERS ID: 972836 Before After
VAERS Form:2
Age:88.0
Sex:Female
Location:Massachusetts
Vaccinated:2021-01-20
Onset:2021-01-24
Submitted:0000-00-00
Entered:2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / UN

Administered by: Senior Living      Purchased by: ??
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-24
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: lorazepam, trazodone, levothyroxine , acetaminophen, multivitamin, senna
Current Illness: no
Preexisting Conditions: Alzheimer''s disease
Allergies: Levofloxacin, ACE inhibitors inhibitors
Diagnostic Lab Data: no
CDC 'Split Type':

Write-up: sudden death


Changed on 5/14/2021

VAERS ID: 972836 Before After
VAERS Form:2
Age:88.0
Sex:Female
Location:Massachusetts
Vaccinated:2021-01-20
Onset:2021-01-24
Submitted:0000-00-00
Entered:2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / UN

Administered by: Senior Living      Purchased by: ??
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-24
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: lorazepam, trazodone, levothyroxine , acetaminophen, multivitamin, senna
Current Illness: no
Preexisting Conditions: Alzheimer''s disease
Allergies: Levofloxacin, ACE inhibitors inhibitors
Diagnostic Lab Data: no
CDC 'Split Type':

Write-up: sudden death

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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=972836&WAYBACKHISTORY=ON

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