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This is VAERS ID 1102698

History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 1102698
VAERS Form:2
Age:83.0
Sex:Female
Location:New Mexico
Vaccinated:2021-02-10
Onset:2021-02-15
Submitted:0000-00-00
Entered:2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 LA / SYR

Administered by: Public      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-16
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: Heart meds, daily vitamins, fish oil, Lyrica
Current Illness: Thyroid, heart issues
Preexisting Conditions: Thyroid, heart
Allergies: None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Death 5 days after 2nd Pfizer vaccine


Changed on 5/7/2021

VAERS ID: 1102698 Before After
VAERS Form:2
Age:83.0
Sex:Female
Location:New Mexico
Vaccinated:2021-02-10
Onset:2021-02-15
Submitted:0000-00-00
Entered:2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 LA / SYR

Administered by: Public      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-16
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: Heart meds, daily vitamins, fish oil, Lyrica
Current Illness: Thyroid, heart issues
Preexisting Conditions: Thyroid, heart
Allergies: None None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Death 5 days after 2nd Pfizer vaccine


Changed on 5/14/2021

VAERS ID: 1102698 Before After
VAERS Form:2
Age:83.0
Sex:Female
Location:New Mexico
Vaccinated:2021-02-10
Onset:2021-02-15
Submitted:0000-00-00
Entered:2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 LA / SYR

Administered by: Public      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-16
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: Heart meds, daily vitamins, fish oil, Lyrica
Current Illness: Thyroid, heart issues
Preexisting Conditions: Thyroid, heart
Allergies: None None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Death 5 days after 2nd Pfizer vaccine

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1102698&WAYBACKHISTORY=ON

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