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This is VAERS ID 1434056

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1434056
VAERS Form:2
Age:91.0
Sex:Male
Location:Washington
Vaccinated:2021-01-15
Onset:2021-05-23
Submitted:0000-00-00
Entered:2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN5318 / 2 UN / UN

Administered by: Unknown      Purchased by: ??
Symptoms: Death, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-23
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Positive COVID-19 PCT test on 05/18/2021
CDC 'Split Type': 2104558

Write-up: Died of COVID-19 illness on 05/23/2021

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1434056&WAYBACKHISTORY=ON

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