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This is VAERS ID 998138

History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 998138
VAERS Form:2
Age:86.0
Sex:Female
Location:Florida
Vaccinated:2021-01-22
Onset:2021-01-22
Submitted:0000-00-00
Entered:2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Arthralgia, Back pain, Chills, Headache, Neck pain, Pain, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-26
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: Daughter unaware of prescriptions
Current Illness: Was hospitalized in December for testing positive for COVID 12/18/2020 - hospitalized for 4 days then released back to nursing home facility.
Preexisting Conditions: Type 2 diabetes; high blood pressure
Allergies: No known allergies
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Same day as vaccination given, developed pain went from arm up to shoulder, to back, to neck to head - right side of body; chills/body aches

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=998138&WAYBACKHISTORY=ON


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