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This is VAERS ID 1272225

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1272225
VAERS Form:2
Age:74.0
Sex:Female
Location:California
Vaccinated:2021-02-28
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Cardiac arrest, Confusional state, Death, Gait inability, Hypersomnia, Pneumonia, Urinary incontinence, Urinary tract infection, Respiratory tract congestion, Neurological symptom, Culture positive, Withdrawal of life support, Computerised tomogram head normal, Magnetic resonance imaging head abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-20
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Chemotherapy drugs
Current Illness: Smoldering Myeloma (precursor to blood cancer)
Preexisting Conditions: Diabetes controlled through diet.
Allergies: None
Diagnostic Lab Data: Pnuemonua culture, MRi. Displayed stroke symptoms.but CT scan showed no stroke.
CDC 'Split Type':

Write-up: Confusion 6 days after shot. Within a week lost ability to walk, became urinary incontinent. Major chest congestion, slept all the time. Rushed by ambulance at day 12.. Diagnosed with pneumonia amd uti. Cardiac arrest at day 14, never woke up. Taken off life support 3/20/21.


Changed on 5/7/2021

VAERS ID: 1272225 Before After
VAERS Form:2
Age:74.0
Sex:Female
Location:California
Vaccinated:2021-02-28
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Cardiac arrest, Confusional state, Death, Gait inability, Hypersomnia, Pneumonia, Urinary incontinence, Urinary tract infection, Respiratory tract congestion, Neurological symptom, Culture positive, Withdrawal of life support, Computerised tomogram head normal, Magnetic resonance imaging head abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-20
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Chemotherapy drugs
Current Illness: Smoldering Myeloma (precursor to blood cancer)
Preexisting Conditions: Diabetes controlled through diet.
Allergies: None None
Diagnostic Lab Data: Pnuemonua culture, MRi. Displayed stroke symptoms.but CT scan showed no stroke.
CDC 'Split Type':

Write-up: Confusion 6 days after shot. Within a week lost ability to walk, became urinary incontinent. Major chest congestion, slept all the time. Rushed by ambulance at day 12.. Diagnosed with pneumonia amd uti. Cardiac arrest at day 14, never woke up. Taken off life support 3/20/21.


Changed on 5/14/2021

VAERS ID: 1272225 Before After
VAERS Form:2
Age:74.0
Sex:Female
Location:California
Vaccinated:2021-02-28
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Cardiac arrest, Confusional state, Death, Gait inability, Hypersomnia, Pneumonia, Urinary incontinence, Urinary tract infection, Respiratory tract congestion, Neurological symptom, Culture positive, Withdrawal of life support, Computerised tomogram head normal, Magnetic resonance imaging head abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-20
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Chemotherapy drugs
Current Illness: Smoldering Myeloma (precursor to blood cancer)
Preexisting Conditions: Diabetes controlled through diet.
Allergies: None None
Diagnostic Lab Data: Pnuemonua culture, MRi. Displayed stroke symptoms.but CT scan showed no stroke.
CDC 'Split Type':

Write-up: Confusion 6 days after shot. Within a week lost ability to walk, became urinary incontinent. Major chest congestion, slept all the time. Rushed by ambulance at day 12.. Diagnosed with pneumonia amd uti. Cardiac arrest at day 14, never woke up. Taken off life support 3/20/21.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1272225&WAYBACKHISTORY=ON

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