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This is VAERS ID 994790

History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 994790
VAERS Form:2
Age:58.0
Sex:Female
Location:Kentucky
Vaccinated:2021-01-31
Onset:2021-02-02
Submitted:0000-00-00
Entered:2021-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 2 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Cardio-respiratory arrest, Death, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-02
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: Prevacid, Hydrocodone, Famotidine, Combivent Respimat, Boniva, Zinc Oxide, Spiriva, Loratadine, Risperdal, Albuterol, Sertraline, Cyanocobalamin, Levothyroxine, Advair, Omega-3 fatty acids, Atorvastatin, Aspirin, Sennoside, Ergocalciferol,
Current Illness: none
Preexisting Conditions: COPD, cad, morbid obesity, depression, bipolar, hypothyroidism, hypertension and gerd.
Allergies: Ibuprofen, ketorolac, morphine,tramadol.
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Resident found unresponsive in room this am at approx. 9:30 am. Resident was observed eating breakfast around 8:45 am. Housekeeper reported seeing resident between breakfast and time found unresponsive. Resident had voiced no complaints. Code was initiated until EMS arrived and transported resident to hospital. Resident expired.

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