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This is VAERS ID 1367997

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1367997
VAERS Form:2
Age:67.0
Sex:Male
Location:New York
Vaccinated:2021-03-11
Onset:2021-05-07
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Death, Electrocardiogram abnormal, Myocardial infarction, Laboratory test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-07
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: Vitamins, hormones, IBS drugs
Current Illness: IBS, diverticulitis
Preexisting Conditions: IBS
Allergies: None
Diagnostic Lab Data: Taken to the ER and admitted, many tests taken to rule out brain stroke. EKG proved massive heart attack.
CDC 'Split Type':

Write-up: Massive Heart Attack resulting in death.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1367997&WAYBACKHISTORY=ON

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