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This is VAERS ID 1629717

History of Changes from the VAERS Wayback Machine

First Appeared on 8/27/2021

VAERS ID: 1629717
VAERS Form:2
Age:84.0
Sex:Female
Location:Utah
Vaccinated:2021-03-01
Onset:2021-03-01
Submitted:0000-00-00
Entered:2021-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / -

Administered by: Other      Purchased by: ??
Symptoms: Asthma, Cardiac arrest, Cough, Death, Dyspnoea, Fall, Fatigue, Loss of consciousness, Resuscitation, Wheezing

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-05-11
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Warfarin, Thyroxin, Metoprolol
Current Illness: unknown
Preexisting Conditions: history of hip fracture
Allergies: none
Diagnostic Lab Data: unknown
CDC 'Split Type':

Write-up: Developed asthmatic like symptoms about two weeks after the 2nd shot. This manifested itself by coughing, shortness of breath, wheezing and fatigue. These symptoms waxed and waned until on the day of her death, she passed out and fell. Shortly after getting to the ER (within 20 minutes), she went into cardiac arrest, was resuscitated but never regained consciousness.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1629717&WAYBACKHISTORY=ON

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