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This is VAERS ID 1505466

History of Changes from the VAERS Wayback Machine

First Appeared on 7/30/2021

VAERS ID: 1505466
VAERS Form:2
Age:77.0
Sex:Male
Location:New York
Vaccinated:2021-07-23
Onset:2021-07-25
Submitted:0000-00-00
Entered:2021-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Death, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-07-25
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: Unknown
Current Illness:
Preexisting Conditions: Hypertension, hyperlipidemia, dementia, slight malnutrition
Allergies: Unknown
Diagnostic Lab Data: Autopsy on 7/26/21
CDC 'Split Type':

Write-up: Death within a few days of second dose of Pfizer COVID-19 vaccine

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1505466&WAYBACKHISTORY=ON

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