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This is VAERS ID 959147

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/22/2021

VAERS ID: 959147
VAERS Form:2
Age:84.0
Sex:Female
Location:Ohio
Vaccinated:2020-12-28
Onset:2021-01-02
Submitted:0000-00-00
Entered:2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E10140 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Death, Jaundice

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: Alzheimer''s disease, Type 2 with chronic kidney disease,
Preexisting Conditions: copd, Depression,psychosis,atherosclerotic heart disease
Allergies: penicillin
Diagnostic Lab Data: none as resident was comfort care only
CDC 'Split Type':

Write-up: Unknown as to any correlation with vaccine as this was a hospice patient that was already experiencing decline. Patient became Jaundice for approximately one week prior to expiring.


Changed on 5/7/2021

VAERS ID: 959147 Before After
VAERS Form:2
Age:84.0
Sex:Female
Location:Ohio
Vaccinated:2020-12-28
Onset:2021-01-02
Submitted:0000-00-00
Entered:2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E10140 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Death, Jaundice

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: Alzheimer''s disease, Type 2 with chronic kidney disease,
Preexisting Conditions: copd, Depression,psychosis,atherosclerotic heart disease
Allergies: penicillin penicillin
Diagnostic Lab Data: none as resident was comfort care only
CDC 'Split Type':

Write-up: Unknown as to any correlation with vaccine as this was a hospice patient that was already experiencing decline. Patient became Jaundice for approximately one week prior to expiring.


Changed on 5/14/2021

VAERS ID: 959147 Before After
VAERS Form:2
Age:84.0
Sex:Female
Location:Ohio
Vaccinated:2020-12-28
Onset:2021-01-02
Submitted:0000-00-00
Entered:2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH E10140 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Death, Jaundice

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: Alzheimer''s disease, Type 2 with chronic kidney disease,
Preexisting Conditions: copd, Depression,psychosis,atherosclerotic heart disease
Allergies: penicillin penicillin
Diagnostic Lab Data: none as resident was comfort care only
CDC 'Split Type':

Write-up: Unknown as to any correlation with vaccine as this was a hospice patient that was already experiencing decline. Patient became Jaundice for approximately one week prior to expiring.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=959147&WAYBACKHISTORY=ON


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