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This is VAERS ID 1494091

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1494091
VAERS Form:2
Age:97.0
Sex:Female
Location:Kentucky
Vaccinated:2021-02-24
Onset:2021-07-12
Submitted:0000-00-00
Entered:2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Chills, Diarrhoea, Dizziness, Dyspnoea, Fatigue, Nausea, Pyrexia, Vomiting, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-07-14
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Diabetes Mellitus, chronic kidney disease, and cardiovascular disease
Allergies: unknown
Diagnostic Lab Data: Patient tested positive for COVID 7-12-21
CDC 'Split Type':

Write-up: Patient was admitted to medical facility on 7-12-21. She had fever, chills, nausea/vomiting, fatigue, shortness of breath, diarrhea, and light headed

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1494091&WAYBACKHISTORY=ON

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