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This is VAERS ID 983192

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 983192
VAERS Form:2
Age:89.0
Sex:Female
Location:Kentucky
Vaccinated:2021-01-05
Onset:2021-01-06
Submitted:0000-00-00
Entered:2021-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 AR / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Dyspnoea, Unresponsive to stimuli, Fluid intake reduced, Decreased appetite, Vital functions abnormal, Hypophagia, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-22
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: None
Current Illness: COVID-19
Preexisting Conditions: Alzheimer''s Disease, Dysphagia, Dementia
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient recevied the COVID-19 vaccine on 1/5/21 by the Vaccine clinic #1. Patient tested positive for COVID-19 by rapid testing on 1/6/21. She demonstrated poor appetite and fluid/food intake and an IV of Normal Saline was initiated on 1/7/21. Oxygen saturation was initiated on 1/12/21 at 4L per nasal cannula. for shortness of breath. On 1/22/21 at 0310 Patient was unresponsive and without vital signs. Orders were for DNR and CPR was not initiated.


Changed on 3/5/2021

VAERS ID: 983192 Before After
VAERS Form:2
Age:89.0
Sex:Female
Location:Kentucky
Vaccinated:2021-01-05
Onset:2021-01-06
Submitted:0000-00-00
Entered:2021-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 AR / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Dyspnoea, Unresponsive to stimuli, Fluid intake reduced, Decreased appetite, Vital functions abnormal, Hypophagia, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-22
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: None
Current Illness: COVID-19
Preexisting Conditions: Alzheimer''s Disease, Dysphagia, Dementia
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient recevied the COVID-19 vaccine on 1/5/21 by the Vaccine clinic #1. Patient tested positive for COVID-19 by rapid testing on 1/6/21. She demonstrated poor appetite and fluid/food intake and an IV of Normal Saline was initiated on 1/7/21. Oxygen saturation was initiated on 1/12/21 at 4L per nasal cannula. for shortness of breath. On 1/22/21 at 0310 Patient was unresponsive and without vital signs. Orders were for DNR and CPR was not initiated.


Changed on 5/7/2021

VAERS ID: 983192 Before After
VAERS Form:2
Age:89.0
Sex:Female
Location:Kentucky
Vaccinated:2021-01-05
Onset:2021-01-06
Submitted:0000-00-00
Entered:2021-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 AR / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Dyspnoea, Unresponsive to stimuli, Fluid intake reduced, Decreased appetite, Vital functions abnormal, Hypophagia, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-22
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: None
Current Illness: COVID-19
Preexisting Conditions: Alzheimer''s Disease, Dysphagia, Dementia
Allergies: NKA NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient recevied the COVID-19 vaccine on 1/5/21 by the Vaccine clinic #1. Patient tested positive for COVID-19 by rapid testing on 1/6/21. She demonstrated poor appetite and fluid/food intake and an IV of Normal Saline was initiated on 1/7/21. Oxygen saturation was initiated on 1/12/21 at 4L per nasal cannula. for shortness of breath. On 1/22/21 at 0310 Patient was unresponsive and without vital signs. Orders were for DNR and CPR was not initiated.


Changed on 5/21/2021

VAERS ID: 983192 Before After
VAERS Form:2
Age:89.0
Sex:Female
Location:Kentucky
Vaccinated:2021-01-05
Onset:2021-01-06
Submitted:0000-00-00
Entered:2021-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 AR / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Dyspnoea, Unresponsive to stimuli, Fluid intake reduced, Decreased appetite, Vital functions abnormal, Hypophagia, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-22
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: None
Current Illness: COVID-19
Preexisting Conditions: Alzheimer''s Disease, Dysphagia, Dementia
Allergies: NKA NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient recevied the COVID-19 vaccine on 1/5/21 by the Vaccine clinic #1. Patient tested positive for COVID-19 by rapid testing on 1/6/21. She demonstrated poor appetite and fluid/food intake and an IV of Normal Saline was initiated on 1/7/21. Oxygen saturation was initiated on 1/12/21 at 4L per nasal cannula. for shortness of breath. On 1/22/21 at 0310 Patient was unresponsive and without vital signs. Orders were for DNR and CPR was not initiated.

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