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This is VAERS ID 1354321

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1354321
VAERS Form:2
Age:78.0
Sex:Male
Location:Minnesota
Vaccinated:2021-04-30
Onset:2021-05-11
Submitted:0000-00-00
Entered:2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0175 / 1 - / -

Administered by: Private      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-11
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Hospice patient death within 60 days of receiving a COVID vaccine

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1354321&WAYBACKHISTORY=ON

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