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This is VAERS ID 1689428

History of Changes from the VAERS Wayback Machine

First Appeared on 9/17/2021

VAERS ID: 1689428
VAERS Form:2
Age:97.0
Sex:Female
Location:Maryland
Vaccinated:2021-03-30
Onset:2021-08-28
Submitted:0000-00-00
Entered:2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Acute myocardial infarction, Asthenia, Cough, Death, Dyspnoea, Pyrexia, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-09-01
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine, vitamin C, aspirin, cimetidine, diclofenac gel, fish oil, gabapentin, Humalog KwikPen, Lantus Solostar, latanoprost, Miralax, pravastatin, Tradjenta, zinc
Current Illness:
Preexisting Conditions: Dementia, diabetes, blindness, GERD, chronic kidney disease, hyperlipidemia, peripheral vascular disease
Allergies: Tramadol (confusion, duloxetine (confusion)
Diagnostic Lab Data: COVID-19 Positive (8/28/2021)
CDC 'Split Type':

Write-up: This patient presented to the emergency department with shortness of breath, cough, fevers, and generalized weakness. Patient tested positive for COVID-19 on 8/28/2021 and was hospitalized for 4 days until she ultimately expired after experiencing a NSTEMI during admission.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1689428&WAYBACKHISTORY=ON

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