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This is VAERS ID 1221145

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1221145
VAERS Form:2
Age:53.0
Sex:Male
Location:Texas
Vaccinated:2021-04-02
Onset:2021-04-13
Submitted:0000-00-00
Entered:2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Dyspnoea, Fall, Headache, Malaise, Rhinorrhoea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-13
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: My uncle unexpectedly passed away during the early morning hours of April 13. He had reported to my aunt that he was having shortness of breath, headaches, and in general not feeling well. She found him sitting up with a clear liquid pouring out of his nose and then he fell over dead.


Changed on 5/7/2021

VAERS ID: 1221145 Before After
VAERS Form:2
Age:53.0
Sex:Male
Location:Texas
Vaccinated:2021-04-02
Onset:2021-04-13
Submitted:0000-00-00
Entered:2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Dyspnoea, Fall, Headache, Malaise, Rhinorrhoea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-13
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: My uncle unexpectedly passed away during the early morning hours of April 13. He had reported to my aunt that he was having shortness of breath, headaches, and in general not feeling well. She found him sitting up with a clear liquid pouring out of his nose and then he fell over dead.


Changed on 5/14/2021

VAERS ID: 1221145 Before After
VAERS Form:2
Age:53.0
Sex:Male
Location:Texas
Vaccinated:2021-04-02
Onset:2021-04-13
Submitted:0000-00-00
Entered:2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / SYR

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Dyspnoea, Fall, Headache, Malaise, Rhinorrhoea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-13
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: My uncle unexpectedly passed away during the early morning hours of April 13. He had reported to my aunt that he was having shortness of breath, headaches, and in general not feeling well. She found him sitting up with a clear liquid pouring out of his nose and then he fell over dead.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1221145&WAYBACKHISTORY=ON

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