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|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH||- / 2||UN / IM|
Administered by: Senior Living Purchased by: ??
Symptoms: Abdominal pain, Death, Pulse absent, Unresponsive to stimuli, Vomiting
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Other Medications: Acetaminophen Suppository Insert 650 mg rectally every 6 hours as needed for pain 1-3 Bisacodyl Suppository 10 MG Insert 1 suppository rectally every 24 hours as needed for constipation COVID-19 mRNA Vaccine (Pfizer) Suspension 30 MCG//0.3M
Preexisting Conditions: C25.9 MALIGNANT NEOPLASM OF PANCREAS, UNSPECIFIED B19.20 UNSPECIFIED VIRAL HEPATITIS C WITHOUT HEPATIC COMA S82.002D UNSPECIFIED FRACTURE OF LEFT PATELLA, SUBSEQUENT ENCOUNTER FOR CLOSED FRACTURE WITH ROUTINE HEALING J44.9 CHRONIC OBSTRUCTIVE PULMONARY DISEASE, UNSPECIFIED F03.90 UNSPECIFIED DEMENTIA WITHOUT BEHAVIORAL DISTURBANCE D64.9 ANEMIA, UNSPECIFIED Z91.81 HISTORY OF FALLING E46 UNSPECIFIED PROTEIN-CALORIE MALNUTRITION G31.84 MILD COGNITIVE IMPAIRMENT, SO STATED I10 ESSENTIAL (PRIMARY) HYPERTENSION G40.89 OTHER SEIZURES F32.9 MAJOR DEPRESSIVE DISORDER, SINGLE EPISODE, UNSPECIFIED F41.9 ANXIETY DISORDER, UNSPECIFIED M62.81 MUSCLE WEAKNESS (GENERALIZED) R26.89 OTHER ABNORMALITIES OF GAIT AND MOBILITY R41.841 COGNITIVE COMMUNICATION DEFICIT Z11
Allergies: Imipenem, Penicillins, Peanut
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Patient with inoperable pancreatic cancer received second Pfizer vaccine approximately 12:30 pm on 1/27/21. At approximataely 16:30, patient complained of abdominal pain and was given Levsin 0.125mg and morphine 5mg orally. At approximately 19:30 patient was found on the floor covered in a large amount of emesis, unresponsive without a pulse.
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