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This is VAERS ID 998637

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 998637
VAERS Form:2
Age:75.0
Sex:Female
Location:North Carolina
Vaccinated:2021-01-13
Onset:2021-01-15
Submitted:0000-00-00
Entered:2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 AR / IM

Administered by: Public      Purchased by: ??
Symptoms: Arrhythmia, Cardiac arrest, Resuscitation, Somnolence, Irregular breathing

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-15
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No known acute illness
Preexisting Conditions: Macular degeneration Dislipidemia
Allergies: None noted
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient noted to have irregular breathing in bed and unable to arouse. Provided life saving measures in the field x 30 minutes and transferred to hospital. Noted to have heart arrhythmia which suspected to cause cardiac arrest.


Changed on 5/7/2021

VAERS ID: 998637 Before After
VAERS Form:2
Age:75.0
Sex:Female
Location:North Carolina
Vaccinated:2021-01-13
Onset:2021-01-15
Submitted:0000-00-00
Entered:2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 AR / IM

Administered by: Public      Purchased by: ??
Symptoms: Arrhythmia, Cardiac arrest, Resuscitation, Somnolence, Irregular breathing

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-15
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No known acute illness
Preexisting Conditions: Macular degeneration Dislipidemia
Allergies: None noted noted
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient noted to have irregular breathing in bed and unable to arouse. Provided life saving measures in the field x 30 minutes and transferred to hospital. Noted to have heart arrhythmia which suspected to cause cardiac arrest.


Changed on 5/21/2021

VAERS ID: 998637 Before After
VAERS Form:2
Age:75.0
Sex:Female
Location:North Carolina
Vaccinated:2021-01-13
Onset:2021-01-15
Submitted:0000-00-00
Entered:2021-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 AR / IM

Administered by: Public      Purchased by: ??
Symptoms: Arrhythmia, Cardiac arrest, Resuscitation, Somnolence, Irregular breathing

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-15
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No known acute illness
Preexisting Conditions: Macular degeneration Dislipidemia
Allergies: None noted noted
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient noted to have irregular breathing in bed and unable to arouse. Provided life saving measures in the field x 30 minutes and transferred to hospital. Noted to have heart arrhythmia which suspected to cause cardiac arrest.

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