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This is VAERS ID 1368670

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1368670
VAERS Form:2
Age:83.0
Sex:Male
Location:Kentucky
Vaccinated:2021-03-11
Onset:2021-05-02
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Hypoxia, Endotracheal intubation, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-02
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: Unknown
Current Illness: COVID-19
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: Tested positive by rapid PCR for COVID-19 on 4/21/2021.
CDC 'Split Type':

Write-up: Admitted to hospital on 5/2/2021 due to hypoxia and ultimately intubated. Family moved to comfort care and he died on 5/2/2021 at 10am.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1368670&WAYBACKHISTORY=ON

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