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This is VAERS ID 1146768

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1146768
VAERS Form:2
Age:66.0
Sex:Female
Location:Kentucky
Vaccinated:2021-03-26
Onset:2021-03-29
Submitted:0000-00-00
Entered:2021-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-29
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: Diabetes, COPD
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Death


Changed on 5/7/2021

VAERS ID: 1146768 Before After
VAERS Form:2
Age:66.0
Sex:Female
Location:Kentucky
Vaccinated:2021-03-26
Onset:2021-03-29
Submitted:0000-00-00
Entered:2021-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-29
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: Diabetes, COPD
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Death


Changed on 5/14/2021

VAERS ID: 1146768 Before After
VAERS Form:2
Age:66.0
Sex:Female
Location:Kentucky
Vaccinated:2021-03-26
Onset:2021-03-29
Submitted:0000-00-00
Entered:2021-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-29
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: Diabetes, COPD
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Death

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1146768&WAYBACKHISTORY=ON


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