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This is VAERS ID 956225

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/22/2021

VAERS ID: 956225
VAERS Form:2
Age:82.0
Sex:Male
Location:California
Vaccinated:2021-01-16
Onset:2021-01-16
Submitted:0000-00-00
Entered:2021-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Unresponsive to stimuli

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:
Current Illness:
Preexisting Conditions:
Allergies: No known allergies
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: Pt monitored by nursing for 30min after inj,pt was stable/no reaction.At ~1hr post inj pt was unresponsive.Pt was a hospice/dnr per director


Changed on 5/7/2021

VAERS ID: 956225 Before After
VAERS Form:2
Age:82.0
Sex:Male
Location:California
Vaccinated:2021-01-16
Onset:2021-01-16
Submitted:0000-00-00
Entered:2021-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Unresponsive to stimuli

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:
Current Illness:
Preexisting Conditions:
Allergies: No known allergies allergies
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: Pt monitored by nursing for 30min after inj,pt was stable/no reaction.At ~1hr post inj pt was unresponsive.Pt was a hospice/dnr per director


Changed on 5/14/2021

VAERS ID: 956225 Before After
VAERS Form:2
Age:82.0
Sex:Male
Location:California
Vaccinated:2021-01-16
Onset:2021-01-16
Submitted:0000-00-00
Entered:2021-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Unresponsive to stimuli

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:
Current Illness:
Preexisting Conditions:
Allergies: No known allergies allergies
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Systemic: Pt monitored by nursing for 30min after inj,pt was stable/no reaction.At ~1hr post inj pt was unresponsive.Pt was a hospice/dnr per director

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=956225&WAYBACKHISTORY=ON


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