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This is VAERS ID 1433813

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1433813
VAERS Form:2
Age:83.0
Sex:Female
Location:Indiana
Vaccinated:2021-02-28
Onset:2021-05-11
Submitted:0000-00-00
Entered:2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 2 - / -

Administered by: Private      Purchased by: ??
Symptoms: Acute myocardial infarction, Acute respiratory failure, Condition aggravated, Coronary artery thrombosis, Death, COVID-19

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-12
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: COVID-19
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Death 5/12/2021 Causes of death listed on death certificate: 1) Acute Myocardial Infarction 2) Acute Coronary Artery Thrombosis 3) COVID-19 Other: Acute Respiratory Failure

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1433813&WAYBACKHISTORY=ON

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