National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 10/15/2021 release of VAERS data:

This is VAERS ID 1025641



Case Details

VAERS ID: 1025641 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-01-11
Onset:2021-01-18
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1686 / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Death, Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-22
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, Metformin, Tamsulosin
Current Illness: No other vaccinations no other illnesses
Preexisting Conditions: diabetes
Allergies: Aspirin, Simvistatin, Tamsulosin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Complained of dizziness on January 18,th seen by MD this date. Passed away on 22nd.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1025641

Government Disclaimer on use of this data


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