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This is VAERS ID 1662120

History of Changes from the VAERS Wayback Machine

First Appeared on 9/3/2021

VAERS ID: 1662120
VAERS Form:2
Age:77.0
Sex:Male
Location:Pennsylvania
Vaccinated:2021-08-25
Onset:2021-08-31
Submitted:0000-00-00
Entered:2021-09-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-08-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Myasthenia gravis Type 2 diabetes mellitus with diabetic chronic kidney disease Essential hypertension
Preexisting Conditions:
Allergies: Lisinopril
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: DEATH

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1662120&WAYBACKHISTORY=ON

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