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This is VAERS ID 987513

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 987513
VAERS Form:2
Age:64.0
Sex:Male
Location:Virginia
Vaccinated:2021-01-27
Onset:2021-01-27
Submitted:0000-00-00
Entered:2021-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 - / -

Administered by: Senior Living      Purchased by: ??
Symptoms: Oxygen saturation decreased, Respiratory distress

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-28
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: UTI And PNA
Preexisting Conditions: COPD , anxiety history of ETOH abuse ,thrombocytopenia
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Note Text: Resident oxygen was going down to 74% during change of shift 3-11, oxygen initiated 3liters via nasal canula per standing order want up to 84-86% NP notified, ordered Prednisone 20mg stat, Rocephin 1gram IM stat administered, Per NP statement if pt''s condition worsening sent him to ER, continue monitoring pt and his oxygen going to 82% increasing distress. Notified Nurses supervisor, 911 was called pt left building at 1819 to Hospital alert oriented. Vs bp. 165/60, temp. 98.3,m pulse 109, res 22, 02. 82%. Resident father notified.


Changed on 5/7/2021

VAERS ID: 987513 Before After
VAERS Form:2
Age:64.0
Sex:Male
Location:Virginia
Vaccinated:2021-01-27
Onset:2021-01-27
Submitted:0000-00-00
Entered:2021-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 - / -

Administered by: Senior Living      Purchased by: ??
Symptoms: Oxygen saturation decreased, Respiratory distress

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-28
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: UTI And PNA
Preexisting Conditions: COPD , anxiety history of ETOH abuse ,thrombocytopenia
Allergies: NKA NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Note Text: Resident oxygen was going down to 74% during change of shift 3-11, oxygen initiated 3liters via nasal canula per standing order want up to 84-86% NP notified, ordered Prednisone 20mg stat, Rocephin 1gram IM stat administered, Per NP statement if pt''s condition worsening sent him to ER, continue monitoring pt and his oxygen going to 82% increasing distress. Notified Nurses supervisor, 911 was called pt left building at 1819 to Hospital alert oriented. Vs bp. 165/60, temp. 98.3,m pulse 109, res 22, 02. 82%. Resident father notified.


Changed on 5/21/2021

VAERS ID: 987513 Before After
VAERS Form:2
Age:64.0
Sex:Male
Location:Virginia
Vaccinated:2021-01-27
Onset:2021-01-27
Submitted:0000-00-00
Entered:2021-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 - / -

Administered by: Senior Living      Purchased by: ??
Symptoms: Oxygen saturation decreased, Respiratory distress

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-28
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: UTI And PNA
Preexisting Conditions: COPD , anxiety history of ETOH abuse ,thrombocytopenia
Allergies: NKA NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Note Text: Resident oxygen was going down to 74% during change of shift 3-11, oxygen initiated 3liters via nasal canula per standing order want up to 84-86% NP notified, ordered Prednisone 20mg stat, Rocephin 1gram IM stat administered, Per NP statement if pt''s condition worsening sent him to ER, continue monitoring pt and his oxygen going to 82% increasing distress. Notified Nurses supervisor, 911 was called pt left building at 1819 to Hospital alert oriented. Vs bp. 165/60, temp. 98.3,m pulse 109, res 22, 02. 82%. Resident father notified.

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