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This is VAERS ID 944998

History of Changes from the VAERS Wayback Machine

First Appeared on 1/15/2021

VAERS ID: 944998
VAERS Form:2
Age:88.0
Sex:Female
Location:Kentucky
Vaccinated:2021-01-04
Onset:2021-01-12
Submitted:0000-00-00
Entered:2021-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Death, Headache, Malaise, Nausea, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-12
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: Resident in skilled nursing facility. Please contact facility if needing all medications.
Current Illness:
Preexisting Conditions: Asthma, hypothyroidism, essential hypertension, atherosclerotic heart disease of native coronary artery, spinal stenosis, fibromyalgia, dementia. Please contact nursing facility for further needed information.
Allergies: Phenazopyridine, Demerol, Pyridium, Penicillins
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 1/11/21 noted with headache, nausea/vomiting, severe melaise. On 1/12/21 resident expired.


Changed on 5/7/2021

VAERS ID: 944998 Before After
VAERS Form:2
Age:88.0
Sex:Female
Location:Kentucky
Vaccinated:2021-01-04
Onset:2021-01-12
Submitted:0000-00-00
Entered:2021-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Death, Headache, Malaise, Nausea, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-12
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: Resident in skilled nursing facility. Please contact facility if needing all medications.
Current Illness:
Preexisting Conditions: Asthma, hypothyroidism, essential hypertension, atherosclerotic heart disease of native coronary artery, spinal stenosis, fibromyalgia, dementia. Please contact nursing facility for further needed information.
Allergies: Phenazopyridine, Demerol, Pyridium, Penicillins Penicillins
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 1/11/21 noted with headache, nausea/vomiting, severe melaise. On 1/12/21 resident expired.


Changed on 5/14/2021

VAERS ID: 944998 Before After
VAERS Form:2
Age:88.0
Sex:Female
Location:Kentucky
Vaccinated:2021-01-04
Onset:2021-01-12
Submitted:0000-00-00
Entered:2021-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Death, Headache, Malaise, Nausea, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-12
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: Resident in skilled nursing facility. Please contact facility if needing all medications.
Current Illness:
Preexisting Conditions: Asthma, hypothyroidism, essential hypertension, atherosclerotic heart disease of native coronary artery, spinal stenosis, fibromyalgia, dementia. Please contact nursing facility for further needed information.
Allergies: Phenazopyridine, Demerol, Pyridium, Penicillins Penicillins
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 1/11/21 noted with headache, nausea/vomiting, severe melaise. On 1/12/21 resident expired.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=944998&WAYBACKHISTORY=ON

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