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This is VAERS ID 1586877

History of Changes from the VAERS Wayback Machine

First Appeared on 8/20/2021

VAERS ID: 1586877
VAERS Form:2
Age:51.0
Sex:Male
Location:New York
Vaccinated:2021-08-18
Onset:2021-08-19
Submitted:0000-00-00
Entered:2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 2 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Death, Resuscitation, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-08-19
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: Folic acid Insulin aspart Sertraline Tylenol Silver sulfadiazine Lyrica Insulin Detemir
Current Illness: Cellulitis/osteomyelitis to right lower extremity amputation stump Diabetes Hypertension Anemia, thrombocytopenia
Preexisting Conditions: Diabetes, Hypertension, Foot ulcers, osteomyelitis, DVT''s, back pain, gangrene
Allergies: Rocephin
Diagnostic Lab Data: None, resident deceased.
CDC 'Split Type':

Write-up: Resident had no issues after receiving vaccination. The next morning he was found in his room laying face down on the floor and unresponsive. CPR was started, 911 called. Unfortunately resident was pronounced dead at 7:55am.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1586877&WAYBACKHISTORY=ON

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