National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1146787

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1146787
VAERS Form:2
Age:93.0
Sex:Male
Location:Unknown
Vaccinated:2021-03-02
Onset:2021-03-15
Submitted:0000-00-00
Entered:2021-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Bladder catheterisation, Death, Decubitus ulcer, Dysphagia, Dyspnoea, Pain, Urinary incontinence, Bedridden, COVID-19

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: death Narrative: Pt has been declining prior to starting COVID vaccine doses; then he got COVID after first dose (VAER reported); and then was admitted to hospice for dyspnea, chronic pain, pressure ulcers, urinary incontinence with foley catheter in place, bedbound, dysphagia.


Changed on 5/7/2021

VAERS ID: 1146787 Before After
VAERS Form:2
Age:93.0
Sex:Male
Location:Unknown
Vaccinated:2021-03-02
Onset:2021-03-15
Submitted:0000-00-00
Entered:2021-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Bladder catheterisation, Death, Decubitus ulcer, Dysphagia, Dyspnoea, Pain, Urinary incontinence, Bedridden, COVID-19

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: death Narrative: Pt has been declining prior to starting COVID vaccine doses; then he got COVID after first dose (VAER reported); and then was admitted to hospice for dyspnea, chronic pain, pressure ulcers, urinary incontinence with foley catheter in place, bedbound, dysphagia.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1146787&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166