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This is VAERS ID 1088723

History of Changes from the VAERS Wayback Machine

First Appeared on 3/11/2021

VAERS ID: 1088723
VAERS Form:2
Age:28.0
Sex:Male
Location:Texas
Vaccinated:2021-02-21
Onset:2021-02-24
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E19266 / 2 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Body temperature increased, Chest X-ray, Computerised tomogram, Death, Dyspnoea, Intensive care, General physical health deterioration, Blood test, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-01
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxin, Depakote, Sertraline, Trazodone, Risperidone, Vit D3
Current Illness:
Preexisting Conditions: Down Syndrome, Autism, CKD, ITP
Allergies: Augmentin
Diagnostic Lab Data: Multiple tests were done that I no longer can access. Multiple COVID tests which were all negative, Chest x-rays, blood work, CT scan
CDC 'Split Type':

Write-up: Patient had 2nd COVID vaccine on 2/21/2021. He started having a temperature on 2/24/2021. Patient then started having trouble breathing. We took him to hospital. He was admitted on 2/25/2021. He steadily declined and was sent to ICU and died on March 1, 2021.


Changed on 5/7/2021

VAERS ID: 1088723 Before After
VAERS Form:2
Age:28.0
Sex:Male
Location:Texas
Vaccinated:2021-02-21
Onset:2021-02-24
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E19266 / 2 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Body temperature increased, Chest X-ray, Computerised tomogram, Death, Dyspnoea, Intensive care, General physical health deterioration, Blood test, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-01
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxin, Depakote, Sertraline, Trazodone, Risperidone, Vit D3
Current Illness:
Preexisting Conditions: Down Syndrome, Autism, CKD, ITP
Allergies: Augmentin Augmentin
Diagnostic Lab Data: Multiple tests were done that I no longer can access. Multiple COVID tests which were all negative, Chest x-rays, blood work, CT scan
CDC 'Split Type':

Write-up: Patient had 2nd COVID vaccine on 2/21/2021. He started having a temperature on 2/24/2021. Patient then started having trouble breathing. We took him to hospital. He was admitted on 2/25/2021. He steadily declined and was sent to ICU and died on March 1, 2021.


Changed on 5/14/2021

VAERS ID: 1088723 Before After
VAERS Form:2
Age:28.0
Sex:Male
Location:Texas
Vaccinated:2021-02-21
Onset:2021-02-24
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E19266 / 2 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Body temperature increased, Chest X-ray, Computerised tomogram, Death, Dyspnoea, Intensive care, General physical health deterioration, Blood test, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-01
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxin, Depakote, Sertraline, Trazodone, Risperidone, Vit D3
Current Illness:
Preexisting Conditions: Down Syndrome, Autism, CKD, ITP
Allergies: Augmentin Augmentin
Diagnostic Lab Data: Multiple tests were done that I no longer can access. Multiple COVID tests which were all negative, Chest x-rays, blood work, CT scan
CDC 'Split Type':

Write-up: Patient had 2nd COVID vaccine on 2/21/2021. He started having a temperature on 2/24/2021. Patient then started having trouble breathing. We took him to hospital. He was admitted on 2/25/2021. He steadily declined and was sent to ICU and died on March 1, 2021.

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