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This is VAERS ID 1272476

History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1272476
VAERS Form:2
Age:75.0
Sex:Female
Location:Oregon
Vaccinated:2021-04-23
Onset:2021-04-24
Submitted:0000-00-00
Entered:2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / SYR

Administered by: Private      Purchased by: ??
Symptoms: Death, Dizziness, Malaise

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-26
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: I do not know
Current Illness: Do not know
Preexisting Conditions: Diabetes
Allergies: Do not know
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: She was quite sick, dizzy, went to ER three times between Saturday and Sunday, they sent her home each time, she died Monday morning.


Changed on 5/7/2021

VAERS ID: 1272476 Before After
VAERS Form:2
Age:75.0
Sex:Female
Location:Oregon
Vaccinated:2021-04-23
Onset:2021-04-24
Submitted:0000-00-00
Entered:2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / SYR

Administered by: Private      Purchased by: ??
Symptoms: Death, Dizziness, Malaise

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-26
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: I do not know
Current Illness: Do not know
Preexisting Conditions: Diabetes
Allergies: Do not know know
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: She was quite sick, dizzy, went to ER three times between Saturday and Sunday, they sent her home each time, she died Monday morning.


Changed on 5/14/2021

VAERS ID: 1272476 Before After
VAERS Form:2
Age:75.0
Sex:Female
Location:Oregon
Vaccinated:2021-04-23
Onset:2021-04-24
Submitted:0000-00-00
Entered:2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / SYR

Administered by: Private      Purchased by: ??
Symptoms: Death, Dizziness, Malaise

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-26
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: I do not know
Current Illness: Do not know
Preexisting Conditions: Diabetes
Allergies: Do not know know
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: She was quite sick, dizzy, went to ER three times between Saturday and Sunday, they sent her home each time, she died Monday morning.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1272476&WAYBACKHISTORY=ON

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