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This is VAERS ID 1016222

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/12/2021

VAERS ID: 1016222
VAERS Form:2
Age:74.0
Sex:Female
Location:Texas
Vaccinated:2021-01-21
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaemia, Angina pectoris, Death, Dyspnoea, Electrocardiogram, Injection site pain, Resuscitation, Syncope, Blood test abnormal, Transfusion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-25
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: Coreg, Ranexa, Bayer low dose Aspirin, Brilinta, Tums, Pantoprazole, Nitro 0.4mg sq prn, Imdur, Rosuvastatin, Glimiperide, Sucralfate
Current Illness: 3 weeks prior to immunzation hospitalized for one day due to symptomatic anemia and got a blood transfusion
Preexisting Conditions: Hypertension, CAD s/p cabg 1996 s/p multiple stents last 2013, history of stroke 1996, high cholesterol, diabetes type 2, iron deficiency anemia
Allergies: Contrast dye, lisinopril
Diagnostic Lab Data: No labs or tests were done, she was transported to hospital for further resuscitation measures but not successful.
CDC 'Split Type':

Write-up: My mom only had site soreness after her covid vaccine on 1/21 which resolved within a couple days. However, she died in the early morning hours of 1/25, she was fine the day before, no sign of injury. We found her collapsed on the ground and although we tried cpr she was already dead. She had gone to the hospital on 12/28 for shortness of breath, angina and symptomatic anemia, her ekg was unchanged and blood work normal except for anemia. The cardiologist did not think a cardiac cath was needed. Her shortness of breath improved with a blood transfusion and a dose of lasix (no heart failure).


Changed on 5/7/2021

VAERS ID: 1016222 Before After
VAERS Form:2
Age:74.0
Sex:Female
Location:Texas
Vaccinated:2021-01-21
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaemia, Angina pectoris, Death, Dyspnoea, Electrocardiogram, Injection site pain, Resuscitation, Syncope, Blood test abnormal, Transfusion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-25
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: Coreg, Ranexa, Bayer low dose Aspirin, Brilinta, Tums, Pantoprazole, Nitro 0.4mg sq prn, Imdur, Rosuvastatin, Glimiperide, Sucralfate
Current Illness: 3 weeks prior to immunzation hospitalized for one day due to symptomatic anemia and got a blood transfusion
Preexisting Conditions: Hypertension, CAD s/p cabg 1996 s/p multiple stents last 2013, history of stroke 1996, high cholesterol, diabetes type 2, iron deficiency anemia
Allergies: Contrast dye, lisinopril lisinopril
Diagnostic Lab Data: No labs or tests were done, she was transported to hospital for further resuscitation measures but not successful.
CDC 'Split Type':

Write-up: My mom only had site soreness after her covid vaccine on 1/21 which resolved within a couple days. However, she died in the early morning hours of 1/25, she was fine the day before, no sign of injury. We found her collapsed on the ground and although we tried cpr she was already dead. She had gone to the hospital on 12/28 for shortness of breath, angina and symptomatic anemia, her ekg was unchanged and blood work normal except for anemia. The cardiologist did not think a cardiac cath was needed. Her shortness of breath improved with a blood transfusion and a dose of lasix (no heart failure).


Changed on 5/14/2021

VAERS ID: 1016222 Before After
VAERS Form:2
Age:74.0
Sex:Female
Location:Texas
Vaccinated:2021-01-21
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9262 / 1 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Anaemia, Angina pectoris, Death, Dyspnoea, Electrocardiogram, Injection site pain, Resuscitation, Syncope, Blood test abnormal, Transfusion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-25
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: Coreg, Ranexa, Bayer low dose Aspirin, Brilinta, Tums, Pantoprazole, Nitro 0.4mg sq prn, Imdur, Rosuvastatin, Glimiperide, Sucralfate
Current Illness: 3 weeks prior to immunzation hospitalized for one day due to symptomatic anemia and got a blood transfusion
Preexisting Conditions: Hypertension, CAD s/p cabg 1996 s/p multiple stents last 2013, history of stroke 1996, high cholesterol, diabetes type 2, iron deficiency anemia
Allergies: Contrast dye, lisinopril lisinopril
Diagnostic Lab Data: No labs or tests were done, she was transported to hospital for further resuscitation measures but not successful.
CDC 'Split Type':

Write-up: My mom only had site soreness after her covid vaccine on 1/21 which resolved within a couple days. However, she died in the early morning hours of 1/25, she was fine the day before, no sign of injury. We found her collapsed on the ground and although we tried cpr she was already dead. She had gone to the hospital on 12/28 for shortness of breath, angina and symptomatic anemia, her ekg was unchanged and blood work normal except for anemia. The cardiologist did not think a cardiac cath was needed. Her shortness of breath improved with a blood transfusion and a dose of lasix (no heart failure).

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