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This is VAERS ID 1272342

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1272342
VAERS Form:2
Age:88.0
Sex:Female
Location:Washington
Vaccinated:2021-04-02
Onset:2021-04-02
Submitted:0000-00-00
Entered:2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Death, Dyspnoea, Nausea, Oxygen saturation decreased, Palpitations, Pneumonia, General physical health deterioration

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-09
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness:
Preexisting Conditions: Diabetes, mild hypertension
Allergies: Penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Developed shortness of breath within 12hrs of 2nd Moderna dose along with heart palpitations and nausea. Admitted to hospital 3 days after shot and quickly developed pnemonia and died 4 days later after blood O2 fell below 80%. Had periods of mild improvements followed by more severe declines each time.


Changed on 5/7/2021

VAERS ID: 1272342 Before After
VAERS Form:2
Age:88.0
Sex:Female
Location:Washington
Vaccinated:2021-04-02
Onset:2021-04-02
Submitted:0000-00-00
Entered:2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Death, Dyspnoea, Nausea, Oxygen saturation decreased, Palpitations, Pneumonia, General physical health deterioration

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-09
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness:
Preexisting Conditions: Diabetes, mild hypertension
Allergies: Penicillin Penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Developed shortness of breath within 12hrs of 2nd Moderna dose along with heart palpitations and nausea. Admitted to hospital 3 days after shot and quickly developed pnemonia and died 4 days later after blood O2 fell below 80%. Had periods of mild improvements followed by more severe declines each time.


Changed on 5/14/2021

VAERS ID: 1272342 Before After
VAERS Form:2
Age:88.0
Sex:Female
Location:Washington
Vaccinated:2021-04-02
Onset:2021-04-02
Submitted:0000-00-00
Entered:2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 AR / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Death, Dyspnoea, Nausea, Oxygen saturation decreased, Palpitations, Pneumonia, General physical health deterioration

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-09
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness:
Preexisting Conditions: Diabetes, mild hypertension
Allergies: Penicillin Penicillin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Developed shortness of breath within 12hrs of 2nd Moderna dose along with heart palpitations and nausea. Admitted to hospital 3 days after shot and quickly developed pnemonia and died 4 days later after blood O2 fell below 80%. Had periods of mild improvements followed by more severe declines each time.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1272342&WAYBACKHISTORY=ON

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