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This is VAERS ID 1218987

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1218987
VAERS Form:2
Age:70.0
Sex:Female
Location:Florida
Vaccinated:2021-02-02
Onset:2021-02-05
Submitted:0000-00-00
Entered:2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Cardiac failure congestive, Death, Dyspnoea, Fatigue

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-29
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? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: amentadine cardadopa dokuspat ometprazole razagiline spirolactone
Current Illness:
Preexisting Conditions: parkinsons
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Date and time of vaccination: (list both if they received both shots): 02/02/21 1100, 02/23/21 1200 Date and time adverse event started: 02/05/21 1100 SOB AFTER FIRST SHOT ,FATIGUE , WAS ADMITTED TO HOSPITAL FOR 7 DAYS , RELEASED AND THEN RETURNED TO THE HOSPITAL , SENT BACK TO , SAW THE DOCTOR 24TH OF MARCH , DOCTOR ADVISED WATER REDUCTION AND THE PATIENT HAD DEVELOPED CHF , PATIENT PAST ON THE 29TH


Changed on 5/7/2021

VAERS ID: 1218987 Before After
VAERS Form:2
Age:70.0
Sex:Female
Location:Florida
Vaccinated:2021-02-02
Onset:2021-02-05
Submitted:0000-00-00
Entered:2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Cardiac failure congestive, Death, Dyspnoea, Fatigue

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-29
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? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: amentadine cardadopa dokuspat ometprazole razagiline spirolactone
Current Illness:
Preexisting Conditions: parkinsons
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Date and time of vaccination: (list both if they received both shots): 02/02/21 1100, 02/23/21 1200 Date and time adverse event started: 02/05/21 1100 SOB AFTER FIRST SHOT ,FATIGUE , WAS ADMITTED TO HOSPITAL FOR 7 DAYS , RELEASED AND THEN RETURNED TO THE HOSPITAL , SENT BACK TO , SAW THE DOCTOR 24TH OF MARCH , DOCTOR ADVISED WATER REDUCTION AND THE PATIENT HAD DEVELOPED CHF , PATIENT PAST ON THE 29TH


Changed on 5/14/2021

VAERS ID: 1218987 Before After
VAERS Form:2
Age:70.0
Sex:Female
Location:Florida
Vaccinated:2021-02-02
Onset:2021-02-05
Submitted:0000-00-00
Entered:2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Cardiac failure congestive, Death, Dyspnoea, Fatigue

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-29
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? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: amentadine cardadopa dokuspat ometprazole razagiline spirolactone
Current Illness:
Preexisting Conditions: parkinsons
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Date and time of vaccination: (list both if they received both shots): 02/02/21 1100, 02/23/21 1200 Date and time adverse event started: 02/05/21 1100 SOB AFTER FIRST SHOT ,FATIGUE , WAS ADMITTED TO HOSPITAL FOR 7 DAYS , RELEASED AND THEN RETURNED TO THE HOSPITAL , SENT BACK TO , SAW THE DOCTOR 24TH OF MARCH , DOCTOR ADVISED WATER REDUCTION AND THE PATIENT HAD DEVELOPED CHF , PATIENT PAST ON THE 29TH

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1218987&WAYBACKHISTORY=ON

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