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This is VAERS ID 1057348

History of Changes from the VAERS Wayback Machine

First Appeared on 2/26/2021

VAERS ID: 1057348
VAERS Form:2
Age:88.0
Sex:Female
Location:Texas
Vaccinated:2021-01-26
Onset:2021-01-28
Submitted:0000-00-00
Entered:2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318/5/31/21 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Dysarthria, Fatigue, Dysstasia, Feeding disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-05
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lasik, blood pressure
Current Illness: congestive heart failure
Preexisting Conditions: congestive heart failure
Allergies: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Extreme Fatigue, slurring speech, unable to stand, eat. Death on 2/5/21


Changed on 5/7/2021

VAERS ID: 1057348 Before After
VAERS Form:2
Age:88.0
Sex:Female
Location:Texas
Vaccinated:2021-01-26
Onset:2021-01-28
Submitted:0000-00-00
Entered:2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318/5/31/21 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Dysarthria, Fatigue, Dysstasia, Feeding disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-05
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lasik, blood pressure
Current Illness: congestive heart failure
Preexisting Conditions: congestive heart failure
Allergies: none none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Extreme Fatigue, slurring speech, unable to stand, eat. Death on 2/5/21


Changed on 5/14/2021

VAERS ID: 1057348 Before After
VAERS Form:2
Age:88.0
Sex:Female
Location:Texas
Vaccinated:2021-01-26
Onset:2021-01-28
Submitted:0000-00-00
Entered:2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318/5/31/21 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Dysarthria, Fatigue, Dysstasia, Feeding disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-05
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lasik, blood pressure
Current Illness: congestive heart failure
Preexisting Conditions: congestive heart failure
Allergies: none none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Extreme Fatigue, slurring speech, unable to stand, eat. Death on 2/5/21

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1057348&WAYBACKHISTORY=ON

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