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This is VAERS ID 1118314

History of Changes from the VAERS Wayback Machine

First Appeared on 3/26/2021

VAERS ID: 1118314
VAERS Form:2
Age:50.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-03-10
Onset:2021-03-10
Submitted:0000-00-00
Entered:2021-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-14
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:
Current Illness: Addison''s Disease, psoariasis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Autopsy
CDC 'Split Type':

Write-up: She received the Johnson and Johnson vaccine on Wednesday and died on Sunday 3/14/2021. Her autopsy is pending.


Changed on 5/7/2021

VAERS ID: 1118314 Before After
VAERS Form:2
Age:50.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-03-10
Onset:2021-03-10
Submitted:0000-00-00
Entered:2021-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-14
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:
Current Illness: Addison''s Disease, psoariasis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Autopsy
CDC 'Split Type':

Write-up: She received the Johnson and Johnson vaccine on Wednesday and died on Sunday 3/14/2021. Her autopsy is pending.


Changed on 5/14/2021

VAERS ID: 1118314 Before After
VAERS Form:2
Age:50.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-03-10
Onset:2021-03-10
Submitted:0000-00-00
Entered:2021-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-14
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:
Current Illness: Addison''s Disease, psoariasis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Autopsy
CDC 'Split Type':

Write-up: She received the Johnson and Johnson vaccine on Wednesday and died on Sunday 3/14/2021. Her autopsy is pending.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1118314&WAYBACKHISTORY=ON


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