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This is VAERS ID 1146022

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1146022
VAERS Form:2
Age:90.0
Sex:Female
Location:New York
Vaccinated:2021-03-22
Onset:2021-03-24
Submitted:0000-00-00
Entered:2021-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Death, Depressed level of consciousness, Hypophagia, Discoloured vomit

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-25
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: tylenol, norvasc, aspirin, celexa, metoprolol tartrate
Current Illness:
Preexisting Conditions: CAD, CHFrEF, dementia, essential tremor
Allergies: no true allergies
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: on 3/24, she had decreased level of alertness, eating less, but continued to drink. On 3/25, appeared a bit better, but still not at baseline. drinking fluids but not eating. she vomited up black material and then passed away on 3/25.


Changed on 5/7/2021

VAERS ID: 1146022 Before After
VAERS Form:2
Age:90.0
Sex:Female
Location:New York
Vaccinated:2021-03-22
Onset:2021-03-24
Submitted:0000-00-00
Entered:2021-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Death, Depressed level of consciousness, Hypophagia, Discoloured vomit

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-25
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: tylenol, norvasc, aspirin, celexa, metoprolol tartrate
Current Illness:
Preexisting Conditions: CAD, CHFrEF, dementia, essential tremor
Allergies: no true allergies allergies
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: on 3/24, she had decreased level of alertness, eating less, but continued to drink. On 3/25, appeared a bit better, but still not at baseline. drinking fluids but not eating. she vomited up black material and then passed away on 3/25.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1146022&WAYBACKHISTORY=ON


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