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This is VAERS ID 1427073

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1427073
VAERS Form:2
Age:81.0
Sex:Male
Location:New Mexico
Vaccinated:2021-01-21
Onset:2021-03-12
Submitted:0000-00-00
Entered:2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Chronic obstructive pulmonary disease, Condition aggravated, Death, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-12
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: COPD, Alzheimer''s, hypertension, dementia
Preexisting Conditions: COPD, Alzheimer''s, hypertension, dementia
Allergies:
Diagnostic Lab Data: COVID-19 antigen positive test collected from Hospital 2/13/2021, and later a positive COVID-19 PCR test collected 3/5/2021.
CDC 'Split Type':

Write-up: Death on 3/12/2021. Primary cause of death was COPD, with COVID-19 listed as an underlying cause.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1427073&WAYBACKHISTORY=ON

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