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This is VAERS ID 1072763

History of Changes from the VAERS Wayback Machine

First Appeared on 3/5/2021

VAERS ID: 1072763
VAERS Form:2
Age:79.0
Sex:Male
Location:Puerto Rico
Vaccinated:2021-02-05
Onset:2021-02-05
Submitted:0000-00-00
Entered:2021-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Dizziness, Dyspnoea, COVID-19, SARS-CoV-2 test positive

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: Unknown
Current Illness: The patient was convalescent from COVID-19, his first positive PCR COVID-19 test was on December 23, 2020. The patient was hospitalize on December 22, 2020 and was check out on December 25, 2020.
Preexisting Conditions: Diabetes and AIDS
Allergies: Unknown
Diagnostic Lab Data: The patient had a PCR test for COVID-19 on February 6, 2021, the result was positive.
CDC 'Split Type': PR-48-21

Write-up: The same day that the person was vaccinated he started feeling dizzy and had difficulty breathing. He was hospitalized from February 5 to February 23. Patient died in the hospital on February 23, 2021


Changed on 5/7/2021

VAERS ID: 1072763 Before After
VAERS Form:2
Age:79.0
Sex:Male
Location:Puerto Rico
Vaccinated:2021-02-05
Onset:2021-02-05
Submitted:0000-00-00
Entered:2021-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Dizziness, Dyspnoea, COVID-19, SARS-CoV-2 test positive

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: Unknown
Current Illness: The patient was convalescent from COVID-19, his first positive PCR COVID-19 test was on December 23, 2020. The patient was hospitalize on December 22, 2020 and was check out on December 25, 2020.
Preexisting Conditions: Diabetes and AIDS
Allergies: Unknown Unknown
Diagnostic Lab Data: The patient had a PCR test for COVID-19 on February 6, 2021, the result was positive.
CDC 'Split Type': PR-48-21

Write-up: The same day that the person was vaccinated he started feeling dizzy and had difficulty breathing. He was hospitalized from February 5 to February 23. Patient died in the hospital on February 23, 2021


Changed on 5/14/2021

VAERS ID: 1072763 Before After
VAERS Form:2
Age:79.0
Sex:Male
Location:Puerto Rico
Vaccinated:2021-02-05
Onset:2021-02-05
Submitted:0000-00-00
Entered:2021-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Dizziness, Dyspnoea, COVID-19, SARS-CoV-2 test positive

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: Unknown
Current Illness: The patient was convalescent from COVID-19, his first positive PCR COVID-19 test was on December 23, 2020. The patient was hospitalize on December 22, 2020 and was check out on December 25, 2020.
Preexisting Conditions: Diabetes and AIDS
Allergies: Unknown Unknown
Diagnostic Lab Data: The patient had a PCR test for COVID-19 on February 6, 2021, the result was positive.
CDC 'Split Type': PR-48-21

Write-up: The same day that the person was vaccinated he started feeling dizzy and had difficulty breathing. He was hospitalized from February 5 to February 23. Patient died in the hospital on February 23, 2021

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1072763&WAYBACKHISTORY=ON


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