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This is VAERS ID 1275910

History of Changes from the VAERS Wayback Machine

First Appeared on 5/7/2021

VAERS ID: 1275910
VAERS Form:2
Age:64.0
Sex:Female
Location:Washington
Vaccinated:2021-03-27
Onset:2021-03-28
Submitted:0000-00-00
Entered:2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Ageusia, Cough, Death, Diarrhoea, Dyspnoea, Fatigue, Nausea, Vomiting, Decreased appetite, COVID-19, SARS-CoV-2 test positive, COVID-19 pneumonia, Exposure to SARS-CoV-2

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Apixaban, diltiazem, glipizide, lisinopril, metformin, metoprolol, mycophenolate, pravastatin, tacrolimus
Current Illness:
Preexisting Conditions: Extensive past medical history including type 2 diabetes, renal transplantation on chronic immunosuppression, atrial fibrillation on anticoagulation, hypertension
Allergies: None
Diagnostic Lab Data: COVID-19 positive 3/28/21 in ED.
CDC 'Split Type':

Write-up: Patient presented to ED on 3/28/21 with the following information: patient reports home daughter was diagnosed with COVID-19 infection a few days ago. For about a week now the patient herself has had severe fatigue, loss of taste, loss of appetite, nausea, vomiting and diarrhea. She denies fevers. She has however had a persistent cough and over the last few days has been short of breath. Tested positive for COVID-19 on 3/27/2021 at outside facility. Last night patient had multiple episodes of diarrhea making her fatigue significantly worse today. Has been drinking a lot of free water. Additionally noted increased cough and shortness of breath. Patient was admitted to the hospital with COVID-19 pneumonia on 3/28/21 and expired on 4/13/21.


Changed on 5/14/2021

VAERS ID: 1275910 Before After
VAERS Form:2
Age:64.0
Sex:Female
Location:Washington
Vaccinated:2021-03-27
Onset:2021-03-28
Submitted:0000-00-00
Entered:2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 2 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Ageusia, Cough, Death, Diarrhoea, Dyspnoea, Fatigue, Nausea, Vomiting, Decreased appetite, COVID-19, SARS-CoV-2 test positive, COVID-19 pneumonia, Exposure to SARS-CoV-2

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Apixaban, diltiazem, glipizide, lisinopril, metformin, metoprolol, mycophenolate, pravastatin, tacrolimus
Current Illness:
Preexisting Conditions: Extensive past medical history including type 2 diabetes, renal transplantation on chronic immunosuppression, atrial fibrillation on anticoagulation, hypertension
Allergies: None None
Diagnostic Lab Data: COVID-19 positive 3/28/21 in ED.
CDC 'Split Type':

Write-up: Patient presented to ED on 3/28/21 with the following information: patient reports home daughter was diagnosed with COVID-19 infection a few days ago. For about a week now the patient herself has had severe fatigue, loss of taste, loss of appetite, nausea, vomiting and diarrhea. She denies fevers. She has however had a persistent cough and over the last few days has been short of breath. Tested positive for COVID-19 on 3/27/2021 at outside facility. Last night patient had multiple episodes of diarrhea making her fatigue significantly worse today. Has been drinking a lot of free water. Additionally noted increased cough and shortness of breath. Patient was admitted to the hospital with COVID-19 pneumonia on 3/28/21 and expired on 4/13/21.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1275910&WAYBACKHISTORY=ON

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