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This is VAERS ID 1043302

History of Changes from the VAERS Wayback Machine

First Appeared on 2/26/2021

VAERS ID: 1043302
VAERS Form:2
Age:73.0
Sex:Male
Location:Texas
Vaccinated:2021-02-05
Onset:2021-02-06
Submitted:0000-00-00
Entered:2021-02-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER EL9269 / 1 - / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Cardiac arrest, Death, Intensive care, Pulse absent, Renal failure, Respiratory arrest, Resuscitation, Unresponsive to stimuli, Clostridium difficile infection, Eye movement disorder, Mechanical ventilation

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-02-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Kidney failure - dialysis treatment 3x per week Recently recovered from stage 3 colon cancer
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: My dad received the Pfizer vaccination on 2/5/21. He was admitted into the hospital the next day for C-Diff bacterial infection. He had been on dialysis treatments for kidney failure treatment since 2017 and had recently been diagnosed with stage 3 colon cancer in June 2020. He had completed his final treatment of chemotherapy on 2/4/21 and several weeks prior had been determined cancer free. On Tuesday 2/9/21 he was released from the hospital and went home. Early Thursday morning 2/11/21 @ approximately 1:30 am CST his eyes rolled back in head and he stopped breathing and was non responsive. My mother called 911 and attempted CPR. Paramedics arrived and were able to successfully get a pulse then transferred him to the hospital. He was put on a ventilator @ the hospital and then transferred to a different hospital a few hours later. He lost pulse/heartbeat several times @ the 2nd hospital he was transferred to. We were not allowed to travel with him or see him b/c of all of the COVID restrictions. We were communicating with the ICU doctor by phone who ultimately communicated to us that there was nothing further that could be done to save his life. He subsequently passed away @ approximately 8:55 am CST on 2/11/21.


Changed on 5/7/2021

VAERS ID: 1043302 Before After
VAERS Form:2
Age:73.0
Sex:Male
Location:Texas
Vaccinated:2021-02-05
Onset:2021-02-06
Submitted:0000-00-00
Entered:2021-02-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER EL9269 / 1 - / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Cardiac arrest, Death, Intensive care, Pulse absent, Renal failure, Respiratory arrest, Resuscitation, Unresponsive to stimuli, Clostridium difficile infection, Eye movement disorder, Mechanical ventilation

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-02-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Kidney failure - dialysis treatment 3x per week Recently recovered from stage 3 colon cancer
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: My dad received the Pfizer vaccination on 2/5/21. He was admitted into the hospital the next day for C-Diff bacterial infection. He had been on dialysis treatments for kidney failure treatment since 2017 and had recently been diagnosed with stage 3 colon cancer in June 2020. He had completed his final treatment of chemotherapy on 2/4/21 and several weeks prior had been determined cancer free. On Tuesday 2/9/21 he was released from the hospital and went home. Early Thursday morning 2/11/21 @ approximately 1:30 am CST his eyes rolled back in head and he stopped breathing and was non responsive. My mother called 911 and attempted CPR. Paramedics arrived and were able to successfully get a pulse then transferred him to the hospital. He was put on a ventilator @ the hospital and then transferred to a different hospital a few hours later. He lost pulse/heartbeat several times @ the 2nd hospital he was transferred to. We were not allowed to travel with him or see him b/c of all of the COVID restrictions. We were communicating with the ICU doctor by phone who ultimately communicated to us that there was nothing further that could be done to save his life. He subsequently passed away @ approximately 8:55 am CST on 2/11/21.


Changed on 5/14/2021

VAERS ID: 1043302 Before After
VAERS Form:2
Age:73.0
Sex:Male
Location:Texas
Vaccinated:2021-02-05
Onset:2021-02-06
Submitted:0000-00-00
Entered:2021-02-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH PFIZER EL9269 / 1 - / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Cardiac arrest, Death, Intensive care, Pulse absent, Renal failure, Respiratory arrest, Resuscitation, Unresponsive to stimuli, Clostridium difficile infection, Eye movement disorder, Mechanical ventilation

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-02-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Kidney failure - dialysis treatment 3x per week Recently recovered from stage 3 colon cancer
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: My dad received the Pfizer vaccination on 2/5/21. He was admitted into the hospital the next day for C-Diff bacterial infection. He had been on dialysis treatments for kidney failure treatment since 2017 and had recently been diagnosed with stage 3 colon cancer in June 2020. He had completed his final treatment of chemotherapy on 2/4/21 and several weeks prior had been determined cancer free. On Tuesday 2/9/21 he was released from the hospital and went home. Early Thursday morning 2/11/21 @ approximately 1:30 am CST his eyes rolled back in head and he stopped breathing and was non responsive. My mother called 911 and attempted CPR. Paramedics arrived and were able to successfully get a pulse then transferred him to the hospital. He was put on a ventilator @ the hospital and then transferred to a different hospital a few hours later. He lost pulse/heartbeat several times @ the 2nd hospital he was transferred to. We were not allowed to travel with him or see him b/c of all of the COVID restrictions. We were communicating with the ICU doctor by phone who ultimately communicated to us that there was nothing further that could be done to save his life. He subsequently passed away @ approximately 8:55 am CST on 2/11/21.

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