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This is VAERS ID 1028921

History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 1028921
VAERS Form:2
Age:85.0
Sex:Male
Location:Florida
Vaccinated:2021-01-26
Onset:2021-01-28
Submitted:0000-00-00
Entered:2021-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Death, Dysphagia, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-05
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: Carbo-Levodopa, Insulin, Lisinopril, Metorprol
Current Illness: Parkinsons, Type 2 Diabetes
Preexisting Conditions: Parkinsons, Type 2 Diabetes
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient had no energy in the first 24 hours and then began a steady decline that started with vomiting after 48 hours, then an inability to swallow and ultimately the patients death on 2/5/21.


Changed on 5/7/2021

VAERS ID: 1028921 Before After
VAERS Form:2
Age:85.0
Sex:Male
Location:Florida
Vaccinated:2021-01-26
Onset:2021-01-28
Submitted:0000-00-00
Entered:2021-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Death, Dysphagia, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-05
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: Carbo-Levodopa, Insulin, Lisinopril, Metorprol
Current Illness: Parkinsons, Type 2 Diabetes
Preexisting Conditions: Parkinsons, Type 2 Diabetes
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient had no energy in the first 24 hours and then began a steady decline that started with vomiting after 48 hours, then an inability to swallow and ultimately the patients death on 2/5/21.


Changed on 5/14/2021

VAERS ID: 1028921 Before After
VAERS Form:2
Age:85.0
Sex:Male
Location:Florida
Vaccinated:2021-01-26
Onset:2021-01-28
Submitted:0000-00-00
Entered:2021-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Death, Dysphagia, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-05
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: Carbo-Levodopa, Insulin, Lisinopril, Metorprol
Current Illness: Parkinsons, Type 2 Diabetes
Preexisting Conditions: Parkinsons, Type 2 Diabetes
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient had no energy in the first 24 hours and then began a steady decline that started with vomiting after 48 hours, then an inability to swallow and ultimately the patients death on 2/5/21.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1028921&WAYBACKHISTORY=ON


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