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This is VAERS ID 1430661

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1430661
VAERS Form:2
Age:85.0
Sex:Male
Location:New Jersey
Vaccinated:2021-02-05
Onset:2021-02-27
Submitted:0000-00-00
Entered:2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 - / -

Administered by: Public      Purchased by: ??
Symptoms: Chills, Death, Fatigue, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-08
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: Atorvastatin, Cholecalciferol, Famotidine, Finasteride, Losartan, Metoprolol succinate, Multaq
Current Illness:
Preexisting Conditions: Bilateral Carotid Stenosis, Hypertension, Hypercholesterolemia, Paroxysmal Atrial Fibrillation, Cva due to embolism of cerebellum artery (hcc)
Allergies: Dabigatran Etexilate Mesylate, Rivaroxaban
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Fatigue, chills, fever, exhaustion. The following Sunday, 9 days after his second dose he went to bed and never woke up.

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