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This is VAERS ID 1087885

History of Changes from the VAERS Wayback Machine

First Appeared on 3/11/2021

VAERS ID: 1087885
VAERS Form:2
Age:68.0
Sex:Male
Location:New York
Vaccinated:2021-03-08
Onset:2021-03-09
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-09
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: Asprin 325mg daily, Viagra 50mg- 1 daily as needed, Levothyroxine 225mcg daily, Metformin 500 mg daily, Lisinopril 40mg daily, Metoprolol 50mg extended release daily, Simvastatin 20mg daily
Current Illness: 2/25: Saw provider for Adrenal Nodule
Preexisting Conditions: Obesity, Hypothyroidism, Pre-diabetes, hypertension, and aortic aneurysm 4.5cm
Allergies: No known allergies
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Patient was found deceased in garage one day post vaccination


Changed on 5/7/2021

VAERS ID: 1087885 Before After
VAERS Form:2
Age:68.0
Sex:Male
Location:New York
Vaccinated:2021-03-08
Onset:2021-03-09
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-09
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: Asprin 325mg daily, Viagra 50mg- 1 daily as needed, Levothyroxine 225mcg daily, Metformin 500 mg daily, Lisinopril 40mg daily, Metoprolol 50mg extended release daily, Simvastatin 20mg daily
Current Illness: 2/25: Saw provider for Adrenal Nodule
Preexisting Conditions: Obesity, Hypothyroidism, Pre-diabetes, hypertension, and aortic aneurysm 4.5cm
Allergies: No known allergies allergies
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Patient was found deceased in garage one day post vaccination


Changed on 5/14/2021

VAERS ID: 1087885 Before After
VAERS Form:2
Age:68.0
Sex:Male
Location:New York
Vaccinated:2021-03-08
Onset:2021-03-09
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-09
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: Asprin 325mg daily, Viagra 50mg- 1 daily as needed, Levothyroxine 225mcg daily, Metformin 500 mg daily, Lisinopril 40mg daily, Metoprolol 50mg extended release daily, Simvastatin 20mg daily
Current Illness: 2/25: Saw provider for Adrenal Nodule
Preexisting Conditions: Obesity, Hypothyroidism, Pre-diabetes, hypertension, and aortic aneurysm 4.5cm
Allergies: No known allergies allergies
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Patient was found deceased in garage one day post vaccination

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1087885&WAYBACKHISTORY=ON

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