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This is VAERS ID 1023803

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/12/2021

VAERS ID: 1023803
VAERS Form:2
Age:92.0
Sex:Female
Location:Illinois
Vaccinated:2021-01-04
Onset:2021-01-06
Submitted:0000-00-00
Entered:2021-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E51686 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Aspiration, Death, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-16
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Was contacted by the person''s daughter on 2/5/21. Patient started vomiting 2 days after vaccination. She aspirated and passed away 1/16/21. Patient had history of stroke and swallowing problems.


Changed on 5/7/2021

VAERS ID: 1023803 Before After
VAERS Form:2
Age:92.0
Sex:Female
Location:Illinois
Vaccinated:2021-01-04
Onset:2021-01-06
Submitted:0000-00-00
Entered:2021-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E51686 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Aspiration, Death, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-16
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Was contacted by the person''s daughter on 2/5/21. Patient started vomiting 2 days after vaccination. She aspirated and passed away 1/16/21. Patient had history of stroke and swallowing problems.


Changed on 5/14/2021

VAERS ID: 1023803 Before After
VAERS Form:2
Age:92.0
Sex:Female
Location:Illinois
Vaccinated:2021-01-04
Onset:2021-01-06
Submitted:0000-00-00
Entered:2021-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E51686 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Aspiration, Death, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-16
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Was contacted by the person''s daughter on 2/5/21. Patient started vomiting 2 days after vaccination. She aspirated and passed away 1/16/21. Patient had history of stroke and swallowing problems.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1023803&WAYBACKHISTORY=ON


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