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This is VAERS ID 1156845

History of Changes from the VAERS Wayback Machine

First Appeared on 4/1/2021

VAERS ID: 1156845
VAERS Form:2
Age:72.0
Sex:Female
Location:Michigan
Vaccinated:2021-03-23
Onset:2021-03-27
Submitted:0000-00-00
Entered:2021-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-27
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: diprosone 0.05% cream, estradiol vaginal cream
Current Illness: none known
Preexisting Conditions: no info in chart
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Patient received COVID vaccine 3/23/2021. The family called the vaccination clinic to inform that the patient died on 3/27/2021. Family believes the vaccine caused the death. I have no other information on this chart.


Changed on 5/7/2021

VAERS ID: 1156845 Before After
VAERS Form:2
Age:72.0
Sex:Female
Location:Michigan
Vaccinated:2021-03-23
Onset:2021-03-27
Submitted:0000-00-00
Entered:2021-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 1 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-27
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: diprosone 0.05% cream, estradiol vaginal cream
Current Illness: none known
Preexisting Conditions: no info in chart
Allergies: none none none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Patient received COVID vaccine 3/23/2021. The family called the vaccination clinic to inform that the patient died on 3/27/2021. Family believes the vaccine caused the death. I have no other information on this chart.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1156845&WAYBACKHISTORY=ON


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