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This is VAERS ID 1460019

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1460019
VAERS Form:2
Age:96.0
Sex:Female
Location:Unknown
Vaccinated:2021-02-05
Onset:2021-04-23
Submitted:0000-00-00
Entered:2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN9581 / 2 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Cardiac failure chronic, Condition aggravated, Death, Pulmonary oedema, General physical health deterioration

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-23
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? No
Previous Vaccinations:
Other Medications: acetaminophen, acidophilus, atorvastatin, ativan, adedronate, albuterol sulfate, Bactrim, doxycline, dilauded, colace, cardizem, benedryl
Current Illness: UTI, CHF
Preexisting Conditions: CHF, chronic pulmonary edema, MRSA, dysphagia, bradycardia, dementia, osteoporosis, rheumatoid arthritis, afib, osteoarthritis, hyperlipidemia
Allergies: allergenic extract-food-shrimp, morphine, Shellfish, Shrimp
Diagnostic Lab Data: during hospice care, labs discontinued.
CDC 'Split Type':

Write-up: Decline noted w/increased hospitalizations over months, including during time of vaccination. CHF and pulmonary edema. Hospice care initiated, end of life care, expired at facility.

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