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This is VAERS ID 1060858

History of Changes from the VAERS Wayback Machine

First Appeared on 3/5/2021

VAERS ID: 1060858
VAERS Form:2
Age:61.0
Sex:Male
Location:Texas
Vaccinated:2021-02-22
Onset:2021-02-22
Submitted:0000-00-00
Entered:2021-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Sudden death, Vomiting, Autopsy, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-23
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: Nifedipine, Klor-con, HCTZ
Current Illness: Hypertension
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: autopsu 2/27/2021
CDC 'Split Type':

Write-up: had lack of appetite before second dose. When received the second dose, he started vomiting on the way home. Was sick on and off for the next few days. Died suddenly on 2/23/2021


Changed on 3/26/2021

VAERS ID: 1060858 Before After
VAERS Form:2
Age:61.0
Sex:Male
Location:Texas
Vaccinated:2021-02-22
Onset:2021-02-22
Submitted:0000-00-00
Entered:2021-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Sudden death, Vomiting, Autopsy, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-23
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: Nifedipine, Klor-con, HCTZ
Current Illness: Hypertension
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: autopsu 2/27/2021
CDC 'Split Type':

Write-up: had lack of appetite before second dose. When received the second dose, he started vomiting on the way home. Was sick on and off for the next few days. Died suddenly on 2/23/2021


Changed on 5/7/2021

VAERS ID: 1060858 Before After
VAERS Form:2
Age:61.0
Sex:Male
Location:Texas
Vaccinated:2021-02-22
Onset:2021-02-22
Submitted:0000-00-00
Entered:2021-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Sudden death, Vomiting, Autopsy, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-23
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: Nifedipine, Klor-con, HCTZ
Current Illness: Hypertension
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: autopsu 2/27/2021
CDC 'Split Type':

Write-up: had lack of appetite before second dose. When received the second dose, he started vomiting on the way home. Was sick on and off for the next few days. Died suddenly on 2/23/2021


Changed on 5/14/2021

VAERS ID: 1060858 Before After
VAERS Form:2
Age:61.0
Sex:Male
Location:Texas
Vaccinated:2021-02-22
Onset:2021-02-22
Submitted:0000-00-00
Entered:2021-02-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Sudden death, Vomiting, Autopsy, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-23
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: Nifedipine, Klor-con, HCTZ
Current Illness: Hypertension
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: autopsu 2/27/2021
CDC 'Split Type':

Write-up: had lack of appetite before second dose. When received the second dose, he started vomiting on the way home. Was sick on and off for the next few days. Died suddenly on 2/23/2021

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1060858&WAYBACKHISTORY=ON

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