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This is VAERS ID 992238

History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 992238
VAERS Form:2
Age:70.0
Sex:Male
Location:Michigan
Vaccinated:2020-12-16
Onset:2021-01-05
Submitted:0000-00-00
Entered:2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-29
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? Yes, days: 24     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metoprolol sitagliptin/metformin glipizide pioglitazone folic acid rivaroxaban tadalafil aspirin atorvastatin lisinopril nephrocaps omeprazole
Current Illness:
Preexisting Conditions: ischemic heart disease hypertension diabetes mellitus type 2 gastroesophageal reflux disease hyperlipidemia obstructive sleep apnea obesity
Allergies: Plavix
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Tested positive for COVID19 on 12-30-2020, Admitted to Hospital on 1/5/2021 with active COVID, Patient died 1/29/2021.


Changed on 5/7/2021

VAERS ID: 992238 Before After
VAERS Form:2
Age:70.0
Sex:Male
Location:Michigan
Vaccinated:2020-12-16
Onset:2021-01-05
Submitted:0000-00-00
Entered:2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-29
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? Yes, days: 24     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metoprolol sitagliptin/metformin glipizide pioglitazone folic acid rivaroxaban tadalafil aspirin atorvastatin lisinopril nephrocaps omeprazole
Current Illness:
Preexisting Conditions: ischemic heart disease hypertension diabetes mellitus type 2 gastroesophageal reflux disease hyperlipidemia obstructive sleep apnea obesity
Allergies: Plavix Plavix
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Tested positive for COVID19 on 12-30-2020, Admitted to Hospital on 1/5/2021 with active COVID, Patient died 1/29/2021.


Changed on 5/14/2021

VAERS ID: 992238 Before After
VAERS Form:2
Age:70.0
Sex:Male
Location:Michigan
Vaccinated:2020-12-16
Onset:2021-01-05
Submitted:0000-00-00
Entered:2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-29
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? Yes, days: 24     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metoprolol sitagliptin/metformin glipizide pioglitazone folic acid rivaroxaban tadalafil aspirin atorvastatin lisinopril nephrocaps omeprazole
Current Illness:
Preexisting Conditions: ischemic heart disease hypertension diabetes mellitus type 2 gastroesophageal reflux disease hyperlipidemia obstructive sleep apnea obesity
Allergies: Plavix Plavix
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Tested positive for COVID19 on 12-30-2020, Admitted to Hospital on 1/5/2021 with active COVID, Patient died 1/29/2021.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=992238&WAYBACKHISTORY=ON


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