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This is VAERS ID 1171601

History of Changes from the VAERS Wayback Machine

First Appeared on 4/8/2021

VAERS ID: 1171601
VAERS Form:2
Age:44.0
Sex:Male
Location:North Carolina
Vaccinated:2021-03-19
Onset:2021-03-20
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Fall, Feeling abnormal, Malaise, Nausea, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Suboxone
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Ibuprofen, aspirin
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Loss of appetite, malaise, nausea, falls, mental fog, death.


Changed on 5/7/2021

VAERS ID: 1171601 Before After
VAERS Form:2
Age:44.0
Sex:Male
Location:North Carolina
Vaccinated:2021-03-19
Onset:2021-03-20
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Fall, Feeling abnormal, Malaise, Nausea, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Suboxone
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Ibuprofen, aspirin aspirin
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Loss of appetite, malaise, nausea, falls, mental fog, death.


Changed on 5/14/2021

VAERS ID: 1171601 Before After
VAERS Form:2
Age:44.0
Sex:Male
Location:North Carolina
Vaccinated:2021-03-19
Onset:2021-03-20
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Fall, Feeling abnormal, Malaise, Nausea, Decreased appetite

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Suboxone
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Ibuprofen, aspirin aspirin
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Loss of appetite, malaise, nausea, falls, mental fog, death.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1171601&WAYBACKHISTORY=ON

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