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This is VAERS ID 1356045

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1356045
VAERS Form:2
Age:45.0
Sex:Female
Location:Ohio
Vaccinated:2021-05-01
Onset:2021-05-03
Submitted:0000-00-00
Entered:2021-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 UN / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-03
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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Hypertension
Allergies: Unknown
Diagnostic Lab Data: .
CDC 'Split Type':

Write-up: Death. Patient died on 5/3/2021; two days after receiving vaccine.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1356045&WAYBACKHISTORY=ON

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