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This is VAERS ID 1046447

History of Changes from the VAERS Wayback Machine

First Appeared on 2/26/2021

VAERS ID: 1046447
VAERS Form:2
Age:38.0
Sex:Female
Location:New Mexico
Vaccinated:2021-02-12
Onset:2021-02-13
Submitted:0000-00-00
Entered:2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Activated partial thromboplastin time prolonged, Alanine aminotransferase increased, Anaemia, Anion gap, Asthenia, Blood albumin decreased, Blood bilirubin increased, Blood creatinine increased, Blood culture positive, Blood fibrinogen decreased, Blood lactic acid, Blood magnesium increased, Blood urea increased, Carbon dioxide decreased, Chest X-ray abnormal, Culture urine positive, Death, Haematocrit decreased, Haemoglobin decreased, Hypotension, International normalised ratio increased, Loss of consciousness, Mouth ulceration, Pancytopenia, Platelet count decreased, Pleural effusion, Pneumonia, Prothrombin time prolonged, Rectal haemorrhage, Red blood cell count decreased, Respiratory failure, Sepsis, Urinary tract infection, White blood cell count decreased, Mental status changes, Blood alkaline phosphatase increased, Culture, Urine analysis normal, Escherichia test positive, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-18
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: Vitamin D3 2000 U daily, Calcium carbonate 500 mg daily, Cyanocobalamin/folic acid/pyridoxine 200mcg-500 mcg-5mg daily, Vitamin B12 1000 mcg daily, Echinacea 450 mg twice daily, St. John''s Wort 300 mg daily, Fish oil 1000mg daily, Vitamin
Current Illness: 1/17/2021 Fell while drunk, right distal humerus fracture, right facial bruising
Preexisting Conditions: Metabolic disorder, anemia
Allergies: Penicillin
Diagnostic Lab Data: 2/17/2021 Labs show pancytopenia with WBCs of 1.4, RBCs 2.18, hemoglobin 6.8, hematocrit 23, platelets 63. PT/INR elevated at 20.4/1.71. PTT elevated at 42. Fibrinogen level low at 147. CO2 level low at 20. Anion gap elevated at 19. Creatinine elevated at 1.63. BUN elevated at 32. Albumin low 1.7. Total bilirubin elevated at 4.5. Alk phos elevated at 154. ALT evaded at 72. Magnesium dated at 2.7. Is low at 48. Lactic acid elevated at 2.9. Urine is negative for infection. COVID-19 test is negative. Cultures x2 obtained. Chest x-ray was done and shows CVP line is in the right atrium. Left lower lobe pneumonia and left pleural effusion. Urine and blood cultures from 2/17/2021 grew Escherichia coli.
CDC 'Split Type':

Write-up: 2/12/2021 Vaccine 2/13/2021 Weakness, oral ulcers 2/17/2021 Brought to ER for loss of consciousness, altered mental status, rectal bleeding; work up showed sepsis, UTI, anemia, pneumonia, pleural effusion, pancytopenia, hypotension; persistent hypotension and respiratory failure 2/18/2021 Passed away at 5:54AM


Changed on 5/7/2021

VAERS ID: 1046447 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:New Mexico
Vaccinated:2021-02-12
Onset:2021-02-13
Submitted:0000-00-00
Entered:2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Activated partial thromboplastin time prolonged, Alanine aminotransferase increased, Anaemia, Anion gap, Asthenia, Blood albumin decreased, Blood bilirubin increased, Blood creatinine increased, Blood culture positive, Blood fibrinogen decreased, Blood lactic acid, Blood magnesium increased, Blood urea increased, Carbon dioxide decreased, Chest X-ray abnormal, Culture urine positive, Death, Haematocrit decreased, Haemoglobin decreased, Hypotension, International normalised ratio increased, Loss of consciousness, Mouth ulceration, Pancytopenia, Platelet count decreased, Pleural effusion, Pneumonia, Prothrombin time prolonged, Rectal haemorrhage, Red blood cell count decreased, Respiratory failure, Sepsis, Urinary tract infection, White blood cell count decreased, Mental status changes, Blood alkaline phosphatase increased, Culture, Urine analysis normal, Escherichia test positive, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-18
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: Vitamin D3 2000 U daily, Calcium carbonate 500 mg daily, Cyanocobalamin/folic acid/pyridoxine 200mcg-500 mcg-5mg daily, Vitamin B12 1000 mcg daily, Echinacea 450 mg twice daily, St. John''s Wort 300 mg daily, Fish oil 1000mg daily, Vitamin
Current Illness: 1/17/2021 Fell while drunk, right distal humerus fracture, right facial bruising
Preexisting Conditions: Metabolic disorder, anemia
Allergies: Penicillin Penicillin
Diagnostic Lab Data: 2/17/2021 Labs show pancytopenia with WBCs of 1.4, RBCs 2.18, hemoglobin 6.8, hematocrit 23, platelets 63. PT/INR elevated at 20.4/1.71. PTT elevated at 42. Fibrinogen level low at 147. CO2 level low at 20. Anion gap elevated at 19. Creatinine elevated at 1.63. BUN elevated at 32. Albumin low 1.7. Total bilirubin elevated at 4.5. Alk phos elevated at 154. ALT evaded at 72. Magnesium dated at 2.7. Is low at 48. Lactic acid elevated at 2.9. Urine is negative for infection. COVID-19 test is negative. Cultures x2 obtained. Chest x-ray was done and shows CVP line is in the right atrium. Left lower lobe pneumonia and left pleural effusion. Urine and blood cultures from 2/17/2021 grew Escherichia coli.
CDC 'Split Type':

Write-up: 2/12/2021 Vaccine 2/13/2021 Weakness, oral ulcers 2/17/2021 Brought to ER for loss of consciousness, altered mental status, rectal bleeding; work up showed sepsis, UTI, anemia, pneumonia, pleural effusion, pancytopenia, hypotension; persistent hypotension and respiratory failure 2/18/2021 Passed away at 5:54AM


Changed on 5/14/2021

VAERS ID: 1046447 Before After
VAERS Form:2
Age:38.0
Sex:Female
Location:New Mexico
Vaccinated:2021-02-12
Onset:2021-02-13
Submitted:0000-00-00
Entered:2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9809 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Activated partial thromboplastin time prolonged, Alanine aminotransferase increased, Anaemia, Anion gap, Asthenia, Blood albumin decreased, Blood bilirubin increased, Blood creatinine increased, Blood culture positive, Blood fibrinogen decreased, Blood lactic acid, Blood magnesium increased, Blood urea increased, Carbon dioxide decreased, Chest X-ray abnormal, Culture urine positive, Death, Haematocrit decreased, Haemoglobin decreased, Hypotension, International normalised ratio increased, Loss of consciousness, Mouth ulceration, Pancytopenia, Platelet count decreased, Pleural effusion, Pneumonia, Prothrombin time prolonged, Rectal haemorrhage, Red blood cell count decreased, Respiratory failure, Sepsis, Urinary tract infection, White blood cell count decreased, Mental status changes, Blood alkaline phosphatase increased, Culture, Urine analysis normal, Escherichia test positive, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-18
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: Vitamin D3 2000 U daily, Calcium carbonate 500 mg daily, Cyanocobalamin/folic acid/pyridoxine 200mcg-500 mcg-5mg daily, Vitamin B12 1000 mcg daily, Echinacea 450 mg twice daily, St. John''s Wort 300 mg daily, Fish oil 1000mg daily, Vitamin
Current Illness: 1/17/2021 Fell while drunk, right distal humerus fracture, right facial bruising
Preexisting Conditions: Metabolic disorder, anemia
Allergies: Penicillin Penicillin
Diagnostic Lab Data: 2/17/2021 Labs show pancytopenia with WBCs of 1.4, RBCs 2.18, hemoglobin 6.8, hematocrit 23, platelets 63. PT/INR elevated at 20.4/1.71. PTT elevated at 42. Fibrinogen level low at 147. CO2 level low at 20. Anion gap elevated at 19. Creatinine elevated at 1.63. BUN elevated at 32. Albumin low 1.7. Total bilirubin elevated at 4.5. Alk phos elevated at 154. ALT evaded at 72. Magnesium dated at 2.7. Is low at 48. Lactic acid elevated at 2.9. Urine is negative for infection. COVID-19 test is negative. Cultures x2 obtained. Chest x-ray was done and shows CVP line is in the right atrium. Left lower lobe pneumonia and left pleural effusion. Urine and blood cultures from 2/17/2021 grew Escherichia coli.
CDC 'Split Type':

Write-up: 2/12/2021 Vaccine 2/13/2021 Weakness, oral ulcers 2/17/2021 Brought to ER for loss of consciousness, altered mental status, rectal bleeding; work up showed sepsis, UTI, anemia, pneumonia, pleural effusion, pancytopenia, hypotension; persistent hypotension and respiratory failure 2/18/2021 Passed away at 5:54AM

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