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This is VAERS ID 1063201

History of Changes from the VAERS Wayback Machine

First Appeared on 3/5/2021

VAERS ID: 1063201
VAERS Form:2
Age:62.0
Sex:Male
Location:Texas
Vaccinated:2021-02-08
Onset:2021-02-09
Submitted:0000-00-00
Entered:2021-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Death, Pulse absent, Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-09
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: Naproxen Beta blocker- unsure of name Flomax
Current Illness: no other illnesses
Preexisting Conditions: High Blood pressure enlarged prostate
Allergies: No known allergies
Diagnostic Lab Data: no medical tests were performed post mortem
CDC 'Split Type':

Write-up: The recipient was feeling well immediately after the vaccination, all day on 2.8 and in the morning of 2.9. His daughter in law text him at 0930 and he did not respond to the text (atypical) and then he missed a morning meeting. His wife was downstairs in a meeting herself and after the meeting was over she called to him and he did not respond. She found him with no pulse and was not breathing. She called 911 and attempted CPR. They did not complete an autopsy, they stated that they believe the cause of death was either an embolism, Heart attack or aneurism. The wife stated that she does not believe the death was due to the vaccination; however, there were no tests completed to prove or disprove.


Changed on 5/7/2021

VAERS ID: 1063201 Before After
VAERS Form:2
Age:62.0
Sex:Male
Location:Texas
Vaccinated:2021-02-08
Onset:2021-02-09
Submitted:0000-00-00
Entered:2021-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Death, Pulse absent, Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-09
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: Naproxen Beta blocker- unsure of name Flomax
Current Illness: no other illnesses
Preexisting Conditions: High Blood pressure enlarged prostate
Allergies: No known allergies allergies
Diagnostic Lab Data: no medical tests were performed post mortem
CDC 'Split Type':

Write-up: The recipient was feeling well immediately after the vaccination, all day on 2.8 and in the morning of 2.9. His daughter in law text him at 0930 and he did not respond to the text (atypical) and then he missed a morning meeting. His wife was downstairs in a meeting herself and after the meeting was over she called to him and he did not respond. She found him with no pulse and was not breathing. She called 911 and attempted CPR. They did not complete an autopsy, they stated that they believe the cause of death was either an embolism, Heart attack or aneurism. The wife stated that she does not believe the death was due to the vaccination; however, there were no tests completed to prove or disprove.


Changed on 5/14/2021

VAERS ID: 1063201 Before After
VAERS Form:2
Age:62.0
Sex:Male
Location:Texas
Vaccinated:2021-02-08
Onset:2021-02-09
Submitted:0000-00-00
Entered:2021-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 LA / IM

Administered by: Work      Purchased by: ??
Symptoms: Death, Pulse absent, Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-09
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: Naproxen Beta blocker- unsure of name Flomax
Current Illness: no other illnesses
Preexisting Conditions: High Blood pressure enlarged prostate
Allergies: No known allergies allergies
Diagnostic Lab Data: no medical tests were performed post mortem
CDC 'Split Type':

Write-up: The recipient was feeling well immediately after the vaccination, all day on 2.8 and in the morning of 2.9. His daughter in law text him at 0930 and he did not respond to the text (atypical) and then he missed a morning meeting. His wife was downstairs in a meeting herself and after the meeting was over she called to him and he did not respond. She found him with no pulse and was not breathing. She called 911 and attempted CPR. They did not complete an autopsy, they stated that they believe the cause of death was either an embolism, Heart attack or aneurism. The wife stated that she does not believe the death was due to the vaccination; however, there were no tests completed to prove or disprove.

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