National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1003382

History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 1003382
VAERS Form:2
Age:83.0
Sex:Female
Location:Alabama
Vaccinated:2021-02-02
Onset:2021-02-03
Submitted:0000-00-00
Entered:2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Bradycardia, Chest pain, Condition aggravated, Death, Diarrhoea, Full blood count, Hypotension, Seizure, Urine analysis, Vomiting, Metabolic function test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-04
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: Aricept, citalopram,carbamazepine, Atorvastatin, gabapentin, calcium citrate, metoprolol, amlodipine, vitamin D
Current Illness: COVID dx on 1/4/2021
Preexisting Conditions: Dementia, epilepsy, HTN, PVD, osteoporosis,
Allergies: PCN, Sulfa ATB
Diagnostic Lab Data: Did order CBC, carbamazepine level, UA and CMP. Results are pending
CDC 'Split Type':

Write-up: Began with vomiting and diarrhea. C/O chest pain. Bradycardia. Hypotension. 2 seizures in 45 minutes after not having one in years. We gave fluids. Gave Zofran. Comfort measures. Pt passed at midnight. Was completely fine one day before. Had minimal issues with COVID though did have a pneumonia that was treated w ATB early on and resolved.


Changed on 5/7/2021

VAERS ID: 1003382 Before After
VAERS Form:2
Age:83.0
Sex:Female
Location:Alabama
Vaccinated:2021-02-02
Onset:2021-02-03
Submitted:0000-00-00
Entered:2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Bradycardia, Chest pain, Condition aggravated, Death, Diarrhoea, Full blood count, Hypotension, Seizure, Urine analysis, Vomiting, Metabolic function test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-04
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: Aricept, citalopram,carbamazepine, Atorvastatin, gabapentin, calcium citrate, metoprolol, amlodipine, vitamin D
Current Illness: COVID dx on 1/4/2021
Preexisting Conditions: Dementia, epilepsy, HTN, PVD, osteoporosis,
Allergies: PCN, Sulfa ATB ATB
Diagnostic Lab Data: Did order CBC, carbamazepine level, UA and CMP. Results are pending
CDC 'Split Type':

Write-up: Began with vomiting and diarrhea. C/O chest pain. Bradycardia. Hypotension. 2 seizures in 45 minutes after not having one in years. We gave fluids. Gave Zofran. Comfort measures. Pt passed at midnight. Was completely fine one day before. Had minimal issues with COVID though did have a pneumonia that was treated w ATB early on and resolved.


Changed on 5/14/2021

VAERS ID: 1003382 Before After
VAERS Form:2
Age:83.0
Sex:Female
Location:Alabama
Vaccinated:2021-02-02
Onset:2021-02-03
Submitted:0000-00-00
Entered:2021-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Bradycardia, Chest pain, Condition aggravated, Death, Diarrhoea, Full blood count, Hypotension, Seizure, Urine analysis, Vomiting, Metabolic function test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-04
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: Aricept, citalopram,carbamazepine, Atorvastatin, gabapentin, calcium citrate, metoprolol, amlodipine, vitamin D
Current Illness: COVID dx on 1/4/2021
Preexisting Conditions: Dementia, epilepsy, HTN, PVD, osteoporosis,
Allergies: PCN, Sulfa ATB ATB
Diagnostic Lab Data: Did order CBC, carbamazepine level, UA and CMP. Results are pending
CDC 'Split Type':

Write-up: Began with vomiting and diarrhea. C/O chest pain. Bradycardia. Hypotension. 2 seizures in 45 minutes after not having one in years. We gave fluids. Gave Zofran. Comfort measures. Pt passed at midnight. Was completely fine one day before. Had minimal issues with COVID though did have a pneumonia that was treated w ATB early on and resolved.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1003382&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166