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This is VAERS ID 1548970

History of Changes from the VAERS Wayback Machine

First Appeared on 8/13/2021

VAERS ID: 1548970
VAERS Form:2
Age:86.0
Sex:Female
Location:Michigan
Vaccinated:2021-01-20
Onset:2021-01-28
Submitted:0000-00-00
Entered:2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Back pain, Chest pain, Malaise, Sudden death, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-28
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Crestor, Prolia, Aspirin, Levothyroxine
Current Illness:
Preexisting Conditions: Thoracic artery aneurysm, hyperparathyroidism, hypothyroidism, mild cognitive impairment
Allergies: PCN, Sulfa, Terbinafine
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: She was not feeling well - vomiting, chest and upper back pain for a few hours prior to visit. Died suddenly while workup in progress

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1548970&WAYBACKHISTORY=ON

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