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This is VAERS ID 1230230

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1230230
VAERS Form:2
Age:64.0
Sex:Male
Location:California
Vaccinated:2021-03-25
Onset:2021-03-26
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Dizziness, Fatigue, Myocardial infarction, Biopsy soft tissue

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-29
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: crevedol amiodorone metroprolol
Current Illness: None
Preexisting Conditions: Heart
Allergies: None
Diagnostic Lab Data: Tissue Biopsy
CDC 'Split Type':

Write-up: Fatigue, dizziness, heart attack and death


Changed on 5/7/2021

VAERS ID: 1230230 Before After
VAERS Form:2
Age:64.0
Sex:Male
Location:California
Vaccinated:2021-03-25
Onset:2021-03-26
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Dizziness, Fatigue, Myocardial infarction, Biopsy soft tissue

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-29
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: crevedol amiodorone metroprolol
Current Illness: None
Preexisting Conditions: Heart
Allergies: None None
Diagnostic Lab Data: Tissue Biopsy
CDC 'Split Type':

Write-up: Fatigue, dizziness, heart attack and death


Changed on 5/14/2021

VAERS ID: 1230230 Before After
VAERS Form:2
Age:64.0
Sex:Male
Location:California
Vaccinated:2021-03-25
Onset:2021-03-26
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Dizziness, Fatigue, Myocardial infarction, Biopsy soft tissue

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-29
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: crevedol amiodorone metroprolol
Current Illness: None
Preexisting Conditions: Heart
Allergies: None None
Diagnostic Lab Data: Tissue Biopsy
CDC 'Split Type':

Write-up: Fatigue, dizziness, heart attack and death

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1230230&WAYBACKHISTORY=ON

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