National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1358813

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1358813
VAERS Form:2
Age:89.0
Sex:Female
Location:Maine
Vaccinated:2021-04-27
Onset:2021-05-06
Submitted:0000-00-00
Entered:2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / SYR

Administered by: Other      Purchased by: ??
Symptoms: Death, Renal failure

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)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insulin atorvastatin
Current Illness:
Preexisting Conditions: Diabetes , congestive heart failure
Allergies:
Diagnostic Lab Data: Unknown if related to vaccine
CDC 'Split Type':

Write-up: Kidney failure/ death

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1358813&WAYBACKHISTORY=ON

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166