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This is VAERS ID 1037207

History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 1037207
VAERS Form:2
Age:39.0
Sex:Female
Location:Utah
Vaccinated:2021-02-01
Onset:2021-02-02
Submitted:0000-00-00
Entered:2021-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private      Purchased by: ??
Symptoms: Death, Incoherent, Injection site pain, Liver function test abnormal, Malaise, Nausea, Pyrexia, Urinary retention, 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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: birth control, and she did do botox
Current Illness: none,
Preexisting Conditions: trigeminal neuralgia - has been in remission since she started doing botox
Allergies: sulfa drugs
Diagnostic Lab Data: contact shock trauma center and the medical examiner
CDC 'Split Type':

Write-up: She had pain in the injection site Tuesday night and then during Tuesday she got worse with nausea and some fever. By Wednesday she was complaining that she could not pee even though she was drinking a lot of fluids. She continued to complain it was the worst she ever felt and then at 0600 Thursday morning she woke us up and said she needed to go to the hospital. We arrived at the hospital just before 0700 and she immediately threw up in the trash can. We went into a treatment room and they took blood and started fluids as she became incoherent. She said she had taken Tylenol so they started a drug to counter that but her liver function was all wrong and they started to look for a hospital that could transplant a liver. She was air evade about 0930 to Medical center and just over 30 hours latter she was dead. There is a pending autopsy. She was a healthy 39 year old mother who got the shots because she worked as a surgical tech and she was the single mother of a 9 year old little girl.


Changed on 5/7/2021

VAERS ID: 1037207 Before After
VAERS Form:2
Age:39.0
Sex:Female
Location:Utah
Vaccinated:2021-02-01
Onset:2021-02-02
Submitted:0000-00-00
Entered:2021-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private      Purchased by: ??
Symptoms: Death, Incoherent, Injection site pain, Liver function test abnormal, Malaise, Nausea, Pyrexia, Urinary retention, 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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: birth control, and she did do botox
Current Illness: none,
Preexisting Conditions: trigeminal neuralgia - has been in remission since she started doing botox
Allergies: sulfa drugs drugs
Diagnostic Lab Data: contact shock trauma center and the medical examiner
CDC 'Split Type':

Write-up: She had pain in the injection site Tuesday night and then during Tuesday she got worse with nausea and some fever. By Wednesday she was complaining that she could not pee even though she was drinking a lot of fluids. She continued to complain it was the worst she ever felt and then at 0600 Thursday morning she woke us up and said she needed to go to the hospital. We arrived at the hospital just before 0700 and she immediately threw up in the trash can. We went into a treatment room and they took blood and started fluids as she became incoherent. She said she had taken Tylenol so they started a drug to counter that but her liver function was all wrong and they started to look for a hospital that could transplant a liver. She was air evade about 0930 to Medical center and just over 30 hours latter she was dead. There is a pending autopsy. She was a healthy 39 year old mother who got the shots because she worked as a surgical tech and she was the single mother of a 9 year old little girl.


Changed on 5/14/2021

VAERS ID: 1037207 Before After
VAERS Form:2
Age:39.0
Sex:Female
Location:Utah
Vaccinated:2021-02-01
Onset:2021-02-02
Submitted:0000-00-00
Entered:2021-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Private      Purchased by: ??
Symptoms: Death, Incoherent, Injection site pain, Liver function test abnormal, Malaise, Nausea, Pyrexia, Urinary retention, 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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: birth control, and she did do botox
Current Illness: none,
Preexisting Conditions: trigeminal neuralgia - has been in remission since she started doing botox
Allergies: sulfa drugs drugs
Diagnostic Lab Data: contact shock trauma center and the medical examiner
CDC 'Split Type':

Write-up: She had pain in the injection site Tuesday night and then during Tuesday she got worse with nausea and some fever. By Wednesday she was complaining that she could not pee even though she was drinking a lot of fluids. She continued to complain it was the worst she ever felt and then at 0600 Thursday morning she woke us up and said she needed to go to the hospital. We arrived at the hospital just before 0700 and she immediately threw up in the trash can. We went into a treatment room and they took blood and started fluids as she became incoherent. She said she had taken Tylenol so they started a drug to counter that but her liver function was all wrong and they started to look for a hospital that could transplant a liver. She was air evade about 0930 to Medical center and just over 30 hours latter she was dead. There is a pending autopsy. She was a healthy 39 year old mother who got the shots because she worked as a surgical tech and she was the single mother of a 9 year old little girl.

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