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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1617486



Case Details

VAERS ID: 1617486 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: California  
Vaccinated:2021-07-25
Onset:2021-07-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA7485 / 1 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chest pain, Death, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-09
   Days after onset: 14
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PERSCRIPTIONS; CARVEDILOL, FUROSEMIDE, LISINOPRIL, SPIRONOLACTONE. DIETARY SUPPLEMENTS; SELENIUM, THIAMIN, FISH OIL, GARLIC, CINIMMON, VITAMIN B-1, C, D, MULTIVITAMIN WITH CALCIUM, MAGNESIUM, ZINC, AND LUTHEUM.
Current Illness: PREVIOUSLY DIAGNOSED WITHCONGESTIVE HEART FAILURE.
Preexisting Conditions: PREVIOUSLY DIAGNOSED WITHCONGESTIVE HEART FAILURE.
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: NEXT DAY AFTER RECIEVING THE VACCINE, MY FATHER EXPERIENCED CHEST PAIN, SHORTNESS OF BREATH, AND WEAKNESS. DUE TO MY FATHER BEING BLIND, HE WAS NOT PROPERLY INFORMED OF ALL THE POTENTIAL RISK, AND SIDE EFFECTS BY THE CLINIC. THE CLINIC GAVE HIM LITERATURE ON THIS, BUT HE COULDNT SEE TO READ ALL THE SIDE EFFECTS THAT MAY BE CAUSED BY TAKING THIS VACCINE, NOT KNOWING HOW CRITICAL IT WAS TO BE SEEN BY A PHYSICIAN, HE STAYED HOME. CONTINUED TO HAVE SHORTNESS OF BREATH, AND WEAKNESS SYMPTOMS UNTIL HE PASSED. MY FATHER DIED ON 8/9/2021.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1617486

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