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This is VAERS ID 1038042

History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 1038042
VAERS Form:2
Age:53.0
Sex:Female
Location:Ohio
Vaccinated:2021-02-05
Onset:2021-02-06
Submitted:0000-00-00
Entered:2021-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / UNK RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Arteriosclerosis, Death, Hypertension

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None.
CDC 'Split Type':

Write-up: Patient expired 02/06/2021. COD as ruled by Coroner "Hypertensive and Atherosclerotic Cardiovascular Disease."


Changed on 5/7/2021

VAERS ID: 1038042 Before After
VAERS Form:2
Age:53.0
Sex:Female
Location:Ohio
Vaccinated:2021-02-05
Onset:2021-02-06
Submitted:0000-00-00
Entered:2021-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / UNK RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Arteriosclerosis, Death, Hypertension

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None.
CDC 'Split Type':

Write-up: Patient expired 02/06/2021. COD as ruled by Coroner "Hypertensive and Atherosclerotic Cardiovascular Disease."


Changed on 5/14/2021

VAERS ID: 1038042 Before After
VAERS Form:2
Age:53.0
Sex:Female
Location:Ohio
Vaccinated:2021-02-05
Onset:2021-02-06
Submitted:0000-00-00
Entered:2021-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / UNK RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Arteriosclerosis, Death, Hypertension

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None.
CDC 'Split Type':

Write-up: Patient expired 02/06/2021. COD as ruled by Coroner "Hypertensive and Atherosclerotic Cardiovascular Disease."

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1038042&WAYBACKHISTORY=ON

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