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This is VAERS ID 983193

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 983193
VAERS Form:2
Age:96.0
Sex:Female
Location:Kentucky
Vaccinated:2021-01-05
Onset:2021-01-05
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: Cough, Dyspnoea exertional, Lethargy, Oxygen saturation decreased, Unresponsive to stimuli, Decreased appetite, Vital functions abnormal, Hypophagia, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-19
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: Citalopram, Divalproex, Levothyroxine
Current Illness: COVID-19
Preexisting Conditions: Dementia, Atrial Fibrillation, Hypothyroidism, Dysphagia
Allergies: Atorvastatin, Donepezil, Corticosteroids
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient began to demonstrate a cough the evening of 1/5/2021, after receiving the COVID-19 vaccine earlier in the afternoon. A rapid COVID-19 test was performed and was positive. She began to demonstrate shortness of breath with exertion on 1/7/21, and lethargy on 1/12/21. Appetite and oral intake began to decline on 1/12/21, and Oxygen saturation dropped on 1/16/21 to 82%, and oxygen was initiated at 3L per nasal cannula. On 1/19/21 at 0414 patient was unresponsive and without vital signs. Orders were for DNR, and CPR was not initiated.


Changed on 5/7/2021

VAERS ID: 983193 Before After
VAERS Form:2
Age:96.0
Sex:Female
Location:Kentucky
Vaccinated:2021-01-05
Onset:2021-01-05
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: Cough, Dyspnoea exertional, Lethargy, Oxygen saturation decreased, Unresponsive to stimuli, Decreased appetite, Vital functions abnormal, Hypophagia, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-19
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: Citalopram, Divalproex, Levothyroxine
Current Illness: COVID-19
Preexisting Conditions: Dementia, Atrial Fibrillation, Hypothyroidism, Dysphagia
Allergies: Atorvastatin, Donepezil, Corticosteroids Corticosteroids
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient began to demonstrate a cough the evening of 1/5/2021, after receiving the COVID-19 vaccine earlier in the afternoon. A rapid COVID-19 test was performed and was positive. She began to demonstrate shortness of breath with exertion on 1/7/21, and lethargy on 1/12/21. Appetite and oral intake began to decline on 1/12/21, and Oxygen saturation dropped on 1/16/21 to 82%, and oxygen was initiated at 3L per nasal cannula. On 1/19/21 at 0414 patient was unresponsive and without vital signs. Orders were for DNR, and CPR was not initiated.


Changed on 5/21/2021

VAERS ID: 983193 Before After
VAERS Form:2
Age:96.0
Sex:Female
Location:Kentucky
Vaccinated:2021-01-05
Onset:2021-01-05
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: Cough, Dyspnoea exertional, Lethargy, Oxygen saturation decreased, Unresponsive to stimuli, Decreased appetite, Vital functions abnormal, Hypophagia, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-19
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: Citalopram, Divalproex, Levothyroxine
Current Illness: COVID-19
Preexisting Conditions: Dementia, Atrial Fibrillation, Hypothyroidism, Dysphagia
Allergies: Atorvastatin, Donepezil, Corticosteroids Corticosteroids
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient began to demonstrate a cough the evening of 1/5/2021, after receiving the COVID-19 vaccine earlier in the afternoon. A rapid COVID-19 test was performed and was positive. She began to demonstrate shortness of breath with exertion on 1/7/21, and lethargy on 1/12/21. Appetite and oral intake began to decline on 1/12/21, and Oxygen saturation dropped on 1/16/21 to 82%, and oxygen was initiated at 3L per nasal cannula. On 1/19/21 at 0414 patient was unresponsive and without vital signs. Orders were for DNR, and CPR was not initiated.

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