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This is VAERS ID 1088175

History of Changes from the VAERS Wayback Machine

First Appeared on 3/11/2021

VAERS ID: 1088175
VAERS Form:2
Age:65.0
Sex:Female
Location:Illinois
Vaccinated:2021-02-03
Onset:2021-02-18
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 AR / IM

Administered by: Other      Purchased by: ??
Symptoms: Ascites, Blood potassium increased, Condition aggravated, Death, Intensive care, Paracentesis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-18
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: 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


Changed on 5/7/2021

VAERS ID: 1088175 Before After
VAERS Form:2
Age:65.0
Sex:Female
Location:Illinois
Vaccinated:2021-02-03
Onset:2021-02-18
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 AR / IM

Administered by: Other      Purchased by: ??
Symptoms: Ascites, Blood potassium increased, Condition aggravated, Death, Intensive care, Paracentesis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-18
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: 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 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


Changed on 5/14/2021

VAERS ID: 1088175 Before After
VAERS Form:2
Age:65.0
Sex:Female
Location:Illinois
Vaccinated:2021-02-03
Onset:2021-02-18
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 1 AR / IM

Administered by: Other      Purchased by: ??
Symptoms: Ascites, Blood potassium increased, Condition aggravated, Death, Intensive care, Paracentesis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-18
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: 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 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

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1088175&WAYBACKHISTORY=ON

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