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This is VAERS ID 955256

History of Changes from the VAERS Wayback Machine

First Appeared on 1/22/2021

VAERS ID: 955256
VAERS Form:2
Age:88.0
Sex:Male
Location:Florida
Vaccinated:2021-01-16
Onset:2021-01-16
Submitted:0000-00-00
Entered:2021-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Cardioversion, Muscle contractions involuntary, Pulse absent, Resuscitation, Unresponsive to stimuli, Immediate post-injection reaction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: None listed
Current Illness: None Listed
Preexisting Conditions: None Listed
Allergies: None Listed
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient was vaccinated in right arm. Within 5 to 10 seconds after vaccination, patient started clinching his hands tightly and became unresponsive. Patient was lowered to the floor and did not exhibit a pulse. CPR was initiated and 911 was called. An AED was used and healthcare professionals onsite continued compressions until the paramedics arrived.

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