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This is VAERS ID 972092

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/29/2021

VAERS ID: 972092
VAERS Form:2
Age:88.0
Sex:Female
Location:California
Vaccinated:2021-01-19
Onset:2021-01-19
Submitted:0000-00-00
Entered:2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-19
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: Diabetes Prescription
Current Illness: Diabetes Mellitus
Preexisting Conditions: Diabetes Mellitus
Allergies: None reported
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Reportedly, this employee''s mother died the night of the vaccine. The details are not known at this time.


Changed on 5/7/2021

VAERS ID: 972092 Before After
VAERS Form:2
Age:88.0
Sex:Female
Location:California
Vaccinated:2021-01-19
Onset:2021-01-19
Submitted:0000-00-00
Entered:2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-19
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: Diabetes Prescription
Current Illness: Diabetes Mellitus
Preexisting Conditions: Diabetes Mellitus
Allergies: None reported reported
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Reportedly, this employee''s mother died the night of the vaccine. The details are not known at this time.


Changed on 5/14/2021

VAERS ID: 972092 Before After
VAERS Form:2
Age:88.0
Sex:Female
Location:California
Vaccinated:2021-01-19
Onset:2021-01-19
Submitted:0000-00-00
Entered:2021-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-19
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: Diabetes Prescription
Current Illness: Diabetes Mellitus
Preexisting Conditions: Diabetes Mellitus
Allergies: None reported reported
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Reportedly, this employee''s mother died the night of the vaccine. The details are not known at this time.

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