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This is VAERS ID 1628365

History of Changes from the VAERS Wayback Machine

First Appeared on 8/27/2021

VAERS ID: 1628365
VAERS Form:2
Age:78.0
Sex:Female
Location:Tennessee
Vaccinated:2021-02-28
Onset:2021-08-15
Submitted:0000-00-00
Entered:2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Death, COVID-19

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-08-15
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated patient deceased from COVID.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1628365&WAYBACKHISTORY=ON

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