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This is VAERS ID 1176806

History of Changes from the VAERS Wayback Machine

First Appeared on 4/8/2021

VAERS ID: 1176806
VAERS Form:2
Age:98.0
Sex:Male
Location:Florida
Vaccinated:2021-03-19
Onset:2021-03-26
Submitted:0000-00-00
Entered:2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP 6955 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Abdominal distension, Death, Dyspnoea, Logorrhoea, Mouth breathing, Protrusion tongue, Tongue discolouration

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-26
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: tamsulosin, aflibercept DO, ranibizumab OS
Current Illness: CAD, BPH, AMD
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: OBJECTIVE: Patient found deceased on March 26, 2021, less than one week post vaccination with Pfizer-BioNTech COVID19 vaccine dose #1. Found by daughter who is also RN and caregiver. Patient found with black tongue protruding slightly from open mouth. Three days post vaccine date and for three days patient found mouth-breathing heavily. When patient?s attention was called to his breathing he immediately resumed normal breathing. Also three days post vaccine date and for three days patient had loosened waist belt and offered complaint of feeling full. Also, Patient was more talkative during the week following vaccination. SUBJECTIVE: Perhaps related to anxiety. OBJECTIVE: Patient had eaten only one avocado per day for his remaining two days of life. Patient had history of stoicism and was known to downplay or deny deviations in physical well-being.


Changed on 5/7/2021

VAERS ID: 1176806 Before After
VAERS Form:2
Age:98.0
Sex:Male
Location:Florida
Vaccinated:2021-03-19
Onset:2021-03-26
Submitted:0000-00-00
Entered:2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP 6955 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Abdominal distension, Death, Dyspnoea, Logorrhoea, Mouth breathing, Protrusion tongue, Tongue discolouration

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-26
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: tamsulosin, aflibercept DO, ranibizumab OS
Current Illness: CAD, BPH, AMD
Preexisting Conditions:
Allergies: NKA NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: OBJECTIVE: Patient found deceased on March 26, 2021, less than one week post vaccination with Pfizer-BioNTech COVID19 vaccine dose #1. Found by daughter who is also RN and caregiver. Patient found with black tongue protruding slightly from open mouth. Three days post vaccine date and for three days patient found mouth-breathing heavily. When patient?s attention was called to his breathing he immediately resumed normal breathing. Also three days post vaccine date and for three days patient had loosened waist belt and offered complaint of feeling full. Also, Patient was more talkative during the week following vaccination. SUBJECTIVE: Perhaps related to anxiety. OBJECTIVE: Patient had eaten only one avocado per day for his remaining two days of life. Patient had history of stoicism and was known to downplay or deny deviations in physical well-being.


Changed on 5/14/2021

VAERS ID: 1176806 Before After
VAERS Form:2
Age:98.0
Sex:Male
Location:Florida
Vaccinated:2021-03-19
Onset:2021-03-26
Submitted:0000-00-00
Entered:2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP 6955 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Abdominal distension, Death, Dyspnoea, Logorrhoea, Mouth breathing, Protrusion tongue, Tongue discolouration

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-26
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: tamsulosin, aflibercept DO, ranibizumab OS
Current Illness: CAD, BPH, AMD
Preexisting Conditions:
Allergies: NKA NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: OBJECTIVE: Patient found deceased on March 26, 2021, less than one week post vaccination with Pfizer-BioNTech COVID19 vaccine dose #1. Found by daughter who is also RN and caregiver. Patient found with black tongue protruding slightly from open mouth. Three days post vaccine date and for three days patient found mouth-breathing heavily. When patient?s attention was called to his breathing he immediately resumed normal breathing. Also three days post vaccine date and for three days patient had loosened waist belt and offered complaint of feeling full. Also, Patient was more talkative during the week following vaccination. SUBJECTIVE: Perhaps related to anxiety. OBJECTIVE: Patient had eaten only one avocado per day for his remaining two days of life. Patient had history of stoicism and was known to downplay or deny deviations in physical well-being.

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