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This is VAERS ID 1052014

History of Changes from the VAERS Wayback Machine

First Appeared on 2/26/2021

VAERS ID: 1052014
VAERS Form:2
Age:91.0
Sex:Female
Location:Texas
Vaccinated:2021-02-06
Onset:2021-02-15
Submitted:0000-00-00
Entered:2021-02-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Death, Dyspnoea, Loss of consciousness, Syncope

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-15
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: Digoxin, Levothyroxine, Atorvastatin, Pregabalin, Sertraline, Monteleucast, Tylenol, Aspirin 81 mg,, Vitamin D3, Vitamin C, probiotic, Benadryl
Current Illness: COPD exascerbation'' UTI flare-up
Preexisting Conditions: Advanced severe COPD, UTI
Allergies: None
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Extreme difficulty breathing upon exertion, collapsed shortly after walking started, loss of conciousness, and death


Changed on 5/7/2021

VAERS ID: 1052014 Before After
VAERS Form:2
Age:91.0
Sex:Female
Location:Texas
Vaccinated:2021-02-06
Onset:2021-02-15
Submitted:0000-00-00
Entered:2021-02-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Death, Dyspnoea, Loss of consciousness, Syncope

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-15
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: Digoxin, Levothyroxine, Atorvastatin, Pregabalin, Sertraline, Monteleucast, Tylenol, Aspirin 81 mg,, Vitamin D3, Vitamin C, probiotic, Benadryl
Current Illness: COPD exascerbation'' UTI flare-up
Preexisting Conditions: Advanced severe COPD, UTI
Allergies: None None
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Extreme difficulty breathing upon exertion, collapsed shortly after walking started, loss of conciousness, and death


Changed on 5/14/2021

VAERS ID: 1052014 Before After
VAERS Form:2
Age:91.0
Sex:Female
Location:Texas
Vaccinated:2021-02-06
Onset:2021-02-15
Submitted:0000-00-00
Entered:2021-02-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9269 / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Death, Dyspnoea, Loss of consciousness, Syncope

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-15
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: Digoxin, Levothyroxine, Atorvastatin, Pregabalin, Sertraline, Monteleucast, Tylenol, Aspirin 81 mg,, Vitamin D3, Vitamin C, probiotic, Benadryl
Current Illness: COPD exascerbation'' UTI flare-up
Preexisting Conditions: Advanced severe COPD, UTI
Allergies: None None
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Extreme difficulty breathing upon exertion, collapsed shortly after walking started, loss of conciousness, and death

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1052014&WAYBACKHISTORY=ON

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