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This is VAERS ID 1027071

History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 1027071
VAERS Form:2
Age:101.0
Sex:Male
Location:Washington
Vaccinated:2021-01-28
Onset:2021-01-29
Submitted:0000-00-00
Entered:2021-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Asthenia, Cerebrovascular accident, Death, Dysarthria, Hemiparesis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-09
Permanent Disability? Yes
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: BP meds x3, Statin, Thyroid, Aspirin, Multivit, Calcium, Vit D
Current Illness: Very elderly
Preexisting Conditions: Previous heart bypass surgery (1995) and later two stents between 1995-2000
Allergies: None
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Adverse reaction to the vaccine started with variable weakness beginning 1/29/2021. On 1/30/21 around 8:30pm, he needed assistance in the bathroom related to weakness and had what was later identified as a stroke with left side weakness and slurred speech. In accordance with his wishes, he had care at home. Due to his advanced age and frailty, a CT scan was not pursued. The 325 mg of aspirin that he was previously taking daily was discontinued. After the stroke, he needed total care. Hospice was established at home. Nursing assistant care was delivered by daughter. Death followed 9 days later (2/9/2021).


Changed on 5/7/2021

VAERS ID: 1027071 Before After
VAERS Form:2
Age:101.0
Sex:Male
Location:Washington
Vaccinated:2021-01-28
Onset:2021-01-29
Submitted:0000-00-00
Entered:2021-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Asthenia, Cerebrovascular accident, Death, Dysarthria, Hemiparesis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-09
Permanent Disability? Yes
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: BP meds x3, Statin, Thyroid, Aspirin, Multivit, Calcium, Vit D
Current Illness: Very elderly
Preexisting Conditions: Previous heart bypass surgery (1995) and later two stents between 1995-2000
Allergies: None None
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Adverse reaction to the vaccine started with variable weakness beginning 1/29/2021. On 1/30/21 around 8:30pm, he needed assistance in the bathroom related to weakness and had what was later identified as a stroke with left side weakness and slurred speech. In accordance with his wishes, he had care at home. Due to his advanced age and frailty, a CT scan was not pursued. The 325 mg of aspirin that he was previously taking daily was discontinued. After the stroke, he needed total care. Hospice was established at home. Nursing assistant care was delivered by daughter. Death followed 9 days later (2/9/2021).


Changed on 5/14/2021

VAERS ID: 1027071 Before After
VAERS Form:2
Age:101.0
Sex:Male
Location:Washington
Vaccinated:2021-01-28
Onset:2021-01-29
Submitted:0000-00-00
Entered:2021-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 2 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Asthenia, Cerebrovascular accident, Death, Dysarthria, Hemiparesis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-09
Permanent Disability? Yes
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: BP meds x3, Statin, Thyroid, Aspirin, Multivit, Calcium, Vit D
Current Illness: Very elderly
Preexisting Conditions: Previous heart bypass surgery (1995) and later two stents between 1995-2000
Allergies: None None
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Adverse reaction to the vaccine started with variable weakness beginning 1/29/2021. On 1/30/21 around 8:30pm, he needed assistance in the bathroom related to weakness and had what was later identified as a stroke with left side weakness and slurred speech. In accordance with his wishes, he had care at home. Due to his advanced age and frailty, a CT scan was not pursued. The 325 mg of aspirin that he was previously taking daily was discontinued. After the stroke, he needed total care. Hospice was established at home. Nursing assistant care was delivered by daughter. Death followed 9 days later (2/9/2021).

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