National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 10/15/2021 release of VAERS data:

This is VAERS ID 1088175

Case Details

VAERS ID: 1088175 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Illinois  
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Ascites, Blood potassium increased, Condition aggravated, Death, Intensive care, Paracentesis
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Acute pancreatitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-18
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Chronic conditions with acute flare ups, last paracentesis for chronic ascites 1/28/2021.
Preexisting Conditions: NASH Cirrhosis, Diabetes, Multiple paracentesis for chronic ascites, back pain, depression, dyslipidemia
Allergies: Amoxicillin and codeine
Diagnostic Lab Data: ER 2/5 for ascites, paracentesis 2/8/2021 with 9900 mls removed. Outpt labs 2/14 and 2/15 with Potassium levels high 6.3 and 6.1. ER 2/17 with ascites discharged to keep scheduled paracentesis later that week. 2/18 returned due to worsening condition, admitted inpatient on hospice to ICU at 1235 passed away at 1815.
CDC Split Type:

Write-up: death within 30 days of vaccination

New Search

Link To This Search Result:

Government Disclaimer on use of this data

Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166