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This is VAERS ID 971969

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/29/2021

VAERS ID: 971969
VAERS Form:2
Age:72.0
Sex:Female
Location:Louisiana
Vaccinated:2021-01-15
Onset:2021-01-21
Submitted:0000-00-00
Entered:2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Seizure

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-21
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, BCC, HLD
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: brought by EMS to ED; seizures at home in bed; 6 Epi and 1 bicarb; no hx of seizure


Changed on 5/7/2021

VAERS ID: 971969 Before After
VAERS Form:2
Age:72.0
Sex:Female
Location:Louisiana
Vaccinated:2021-01-15
Onset:2021-01-21
Submitted:0000-00-00
Entered:2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Seizure

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-21
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, BCC, HLD
Allergies: NKA NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: brought by EMS to ED; seizures at home in bed; 6 Epi and 1 bicarb; no hx of seizure


Changed on 5/14/2021

VAERS ID: 971969 Before After
VAERS Form:2
Age:72.0
Sex:Female
Location:Louisiana
Vaccinated:2021-01-15
Onset:2021-01-21
Submitted:0000-00-00
Entered:2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1283 / 1 - / IM

Administered by: Private      Purchased by: ??
Symptoms: Seizure

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-21
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, BCC, HLD
Allergies: NKA NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: brought by EMS to ED; seizures at home in bed; 6 Epi and 1 bicarb; no hx of seizure

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=971969&WAYBACKHISTORY=ON


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