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This is VAERS ID 1029790

History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 1029790
VAERS Form:2
Age:95.0
Sex:Female
Location:California
Vaccinated:2021-02-05
Onset:2021-02-05
Submitted:0000-00-00
Entered:2021-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NOT PROVIDED TO / 2 - / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Death

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: Escitalophram Over the Counter - B12, Iron, Calcium, Senna
Current Illness: Dementia
Preexisting Conditions: Anemia, Osteoporosis,
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Taken to Emergency about 8 hours later and died in ER


Changed on 5/7/2021

VAERS ID: 1029790 Before After
VAERS Form:2
Age:95.0
Sex:Female
Location:California
Vaccinated:2021-02-05
Onset:2021-02-05
Submitted:0000-00-00
Entered:2021-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NOT PROVIDED TO / 2 - / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Death

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: Escitalophram Over the Counter - B12, Iron, Calcium, Senna
Current Illness: Dementia
Preexisting Conditions: Anemia, Osteoporosis,
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Taken to Emergency about 8 hours later and died in ER


Changed on 5/14/2021

VAERS ID: 1029790 Before After
VAERS Form:2
Age:95.0
Sex:Female
Location:California
Vaccinated:2021-02-05
Onset:2021-02-05
Submitted:0000-00-00
Entered:2021-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NOT PROVIDED TO / 2 - / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Death

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: Escitalophram Over the Counter - B12, Iron, Calcium, Senna
Current Illness: Dementia
Preexisting Conditions: Anemia, Osteoporosis,
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Taken to Emergency about 8 hours later and died in ER

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1029790&WAYBACKHISTORY=ON


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