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This is VAERS ID 1130720

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1130720
VAERS Form:2
Age:68.0
Sex:Male
Location:Unknown
Vaccinated:2021-03-19
Onset:2021-03-19
Submitted:0000-00-00
Entered:2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Fatigue, Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-19
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:
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Tiredness Death 03/19/2021 Cause of death: Ruptured Myocardial infarction

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1130720&WAYBACKHISTORY=ON


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