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This is VAERS ID 1180640

History of Changes from the VAERS Wayback Machine

First Appeared on 4/8/2021

VAERS ID: 1180640
VAERS Form:2
Age:66.0
Sex:Male
Location:Kentucky
Vaccinated:2021-04-03
Onset:2021-04-04
Submitted:0000-00-00
Entered:2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Death, Dyspnoea, Fatigue, Abnormal sleep-related event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-08
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:
Current Illness:
Preexisting Conditions: HTN, HLD, COPD, 1-2 PPD smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 4/4/21 woke up more tired than usual. Progressed from there, prominent fatigue for the next couple days, slept on the couch on and off for a couple days which was unusual for him. Mild SOA and weakness 4/7/21. Died in his sleep into the morning of 4/8/21.


Changed on 5/7/2021

VAERS ID: 1180640 Before After
VAERS Form:2
Age:66.0
Sex:Male
Location:Kentucky
Vaccinated:2021-04-03
Onset:2021-04-04
Submitted:0000-00-00
Entered:2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Death, Dyspnoea, Fatigue, Abnormal sleep-related event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-08
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:
Current Illness:
Preexisting Conditions: HTN, HLD, COPD, 1-2 PPD smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 4/4/21 woke up more tired than usual. Progressed from there, prominent fatigue for the next couple days, slept on the couch on and off for a couple days which was unusual for him. Mild SOA and weakness 4/7/21. Died in his sleep into the morning of 4/8/21.


Changed on 5/14/2021

VAERS ID: 1180640 Before After
VAERS Form:2
Age:66.0
Sex:Male
Location:Kentucky
Vaccinated:2021-04-03
Onset:2021-04-04
Submitted:0000-00-00
Entered:2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Death, Dyspnoea, Fatigue, Abnormal sleep-related event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-08
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:
Current Illness:
Preexisting Conditions: HTN, HLD, COPD, 1-2 PPD smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 4/4/21 woke up more tired than usual. Progressed from there, prominent fatigue for the next couple days, slept on the couch on and off for a couple days which was unusual for him. Mild SOA and weakness 4/7/21. Died in his sleep into the morning of 4/8/21.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1180640&WAYBACKHISTORY=ON

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