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This is VAERS ID 1087952

History of Changes from the VAERS Wayback Machine

First Appeared on 3/11/2021

VAERS ID: 1087952
VAERS Form:2
Age:89.0
Sex:Female
Location:Minnesota
Vaccinated:2020-12-27
Onset:2020-12-27
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Death, Fall, Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-12-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, donepezil, Memantine, Sertaline
Current Illness: Hypertention, COPD, Atrial Fibrilation
Preexisting Conditions:
Allergies: Sulfa, Risperdal
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Resident fell out of her chair and was transferred to the ER with a diagnosis of a Mio cardial infarction and passed away in the ER.


Changed on 5/7/2021

VAERS ID: 1087952 Before After
VAERS Form:2
Age:89.0
Sex:Female
Location:Minnesota
Vaccinated:2020-12-27
Onset:2020-12-27
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Death, Fall, Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-12-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, donepezil, Memantine, Sertaline
Current Illness: Hypertention, COPD, Atrial Fibrilation
Preexisting Conditions:
Allergies: Sulfa, Risperdal Risperdal
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Resident fell out of her chair and was transferred to the ER with a diagnosis of a Mio cardial infarction and passed away in the ER.


Changed on 5/14/2021

VAERS ID: 1087952 Before After
VAERS Form:2
Age:89.0
Sex:Female
Location:Minnesota
Vaccinated:2020-12-27
Onset:2020-12-27
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Death, Fall, Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-12-27
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, donepezil, Memantine, Sertaline
Current Illness: Hypertention, COPD, Atrial Fibrilation
Preexisting Conditions:
Allergies: Sulfa, Risperdal Risperdal
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Resident fell out of her chair and was transferred to the ER with a diagnosis of a Mio cardial infarction and passed away in the ER.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1087952&WAYBACKHISTORY=ON

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