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This is VAERS ID 1111249

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1111249
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-01-01
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Upper gastrointestinal haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-01
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? No
Previous Vaccinations:
Other Medications: BEHEPAN [CYANOCOBALAMIN]; ENALAPRIL; ESOMEPRAZOLE; KALCIPOS-D; FURIX [FUROSEMIDE]; XARELTO; DUROFERON; METOPROLOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Atrial fibrillation; Cardiac failure; Cognitive impairment; Hypertension; Ulcer stomach (past ulcer x 2)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': SEPFIZER INC2021118996

Write-up: ACUTE Upper gastrointestinal bleeding; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number SE-MPA-1611914132186. A 95-year-old female patient received BNT162B2 (COMIRNATY), via unspecified route in Jan2021 at 0,3ml single dose for COVID-19 immunization. Concomitant medications were cyanocobalamin (BEHEPAN), ferrous sulfate (DUROFERON), furosemide (FURIX), calcium carbonate, colecalciferol (KALCIPOS-D), rivaroxaban (XARELTO), enalapril, esomeprazole, metoprolol. The patient''s medical history and concurrent conditions included: Cognitive impairment, Hypertension, Ulcer stomach, Cardiac failure, Atrial fibrillation. On unknown date in Jan2021 the patient experienced acute Upper gastrointestinal bleeding and died. The woman has been found lifeless in her bed in the morning the day after the vaccination. Fresh black blood in the oral cavity that had run out on the blanket. Death was confirmed during a home visit by the reporter. No follow-up attempts possible. No further information expected. Lot/batch number was not provided and unable to obtain ; Reported Cause(s) of Death: Upper gastrointestinal bleeding

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1111249&WAYBACKHISTORY=ON

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