| Days after vaccination:||160
|Vaccination / Manufacturer
||Lot / Dose
||Site / Route|
|COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH
||EN9581 / 2
||- / -
Administered by: Senior Living Purchased by: ?
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad)
Life Threatening? No
Birth Defect? No
Date died: 2021-07-15
Days after onset: 0
Permanent Disability? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Other Medications: apap, acidophilus, ativan, plavix, lasix, potassium chloride
Current Illness: Conjunctivitis
Preexisting Conditions: Dementia, CHF/HTN, Osteoporosis,
Allergies: no known drug allergies. Laundry soap, Scented products
Diagnostic Lab Data: none during end of life hospice care.
CDC Split Type:
Write-up: Stable at time of vaccine 1/15/21 and 2/5/21, Transferred to ER for pocketing food, Left facial drooping and left sided weakness on 7/4/21. Returned from hospital 7/14/21 w/gastrostomy nutritional status and hospice care. She expired w/end of life hospice care in place on 7/15/21.