National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1033444

History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 1033444
VAERS Form:2
Age:80.0
Sex:Male
Location:California
Vaccinated:2021-01-16
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / UN

Administered by: Private      Purchased by: ??
Symptoms: Cardiac failure congestive, Condition aggravated

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-25
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: congestive heart disease medications
Current Illness: Addison''s disease, abdominal hernia
Preexisting Conditions: Congestive heart disease Addison''s disease
Allergies: sulfa
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: symptoms of ongoing congestive heart disease just progressed


Changed on 5/7/2021

VAERS ID: 1033444 Before After
VAERS Form:2
Age:80.0
Sex:Male
Location:California
Vaccinated:2021-01-16
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / UN

Administered by: Private      Purchased by: ??
Symptoms: Cardiac failure congestive, Condition aggravated

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-25
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: congestive heart disease medications
Current Illness: Addison''s disease, abdominal hernia
Preexisting Conditions: Congestive heart disease Addison''s disease
Allergies: sulfa sulfa
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: symptoms of ongoing congestive heart disease just progressed


Changed on 5/14/2021

VAERS ID: 1033444 Before After
VAERS Form:2
Age:80.0
Sex:Male
Location:California
Vaccinated:2021-01-16
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / UN

Administered by: Private      Purchased by: ??
Symptoms: Cardiac failure congestive, Condition aggravated

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-25
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: congestive heart disease medications
Current Illness: Addison''s disease, abdominal hernia
Preexisting Conditions: Congestive heart disease Addison''s disease
Allergies: sulfa sulfa
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: symptoms of ongoing congestive heart disease just progressed

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1033444&WAYBACKHISTORY=ON


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