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This is VAERS ID 1160227

History of Changes from the VAERS Wayback Machine

First Appeared on 4/8/2021

VAERS ID: 1160227
VAERS Form:2
Age:85.0
Sex:Female
Location:Alaska
Vaccinated:2021-03-17
Onset:2021-03-22
Submitted:0000-00-00
Entered:2021-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-22
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: Aspirin, Cardizem, lisinopril, magnesium, potassium, Symbicort, trazodone, vitamin c, risperidone, vitamin D
Current Illness:
Preexisting Conditions: COPD, dementia, oxygen dependent, atrial fibrillation,
Allergies: penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: death 5 days later


Changed on 5/7/2021

VAERS ID: 1160227 Before After
VAERS Form:2
Age:85.0
Sex:Female
Location:Alaska
Vaccinated:2021-03-17
Onset:2021-03-22
Submitted:0000-00-00
Entered:2021-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-22
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: Aspirin, Cardizem, lisinopril, magnesium, potassium, Symbicort, trazodone, vitamin c, risperidone, vitamin D
Current Illness:
Preexisting Conditions: COPD, dementia, oxygen dependent, atrial fibrillation,
Allergies: penicillin penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: death 5 days later


Changed on 5/14/2021

VAERS ID: 1160227 Before After
VAERS Form:2
Age:85.0
Sex:Female
Location:Alaska
Vaccinated:2021-03-17
Onset:2021-03-22
Submitted:0000-00-00
Entered:2021-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-22
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: Aspirin, Cardizem, lisinopril, magnesium, potassium, Symbicort, trazodone, vitamin c, risperidone, vitamin D
Current Illness:
Preexisting Conditions: COPD, dementia, oxygen dependent, atrial fibrillation,
Allergies: penicillin penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: death 5 days later

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1160227&WAYBACKHISTORY=ON


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