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This is VAERS ID 974489

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History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 974489
VAERS Form:2
Age:80.0
Sex:Female
Location:Michigan
Vaccinated:2021-01-19
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-25
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: Ipratropium and prednisone prescribed on 1/6/2021. Other medications include albuterol inhaler & nebulizer solution, calcium carbonate, cetirizine, cyclobenzaprine, fluticasone nasal spray, Advair HFA, home oxygen, guaifenesin, lidocaine 5
Current Illness: Asthma, COPD exacerbation.
Preexisting Conditions: Essential hypertension, dyslipidemia, allergic rhinitis, COPD, brain aneurysm, hiatal hernia, tobacco abuse, hyponatremia, normochromic, normocytic anemia, hx of MI, anxiety, intractable pain.
Allergies: Clarithromycin, cefaclor, ciprofloxacin, codeine, erythromycin, penicillins, tramadol, naproxen. All of these cause shortness of breath. Generic lisinopril-HCTZ caused severe headache and nausea. Statins cause joint pain and stiffness, couldn''t walk.
Diagnostic Lab Data: Medical Examiner does not believe this is related to vaccine.
CDC 'Split Type':

Write-up: No immediate symptoms. No symptoms ever reported. Patient was found dead in her home on 1/25/2021 and last seen on 1/24/2021. Neighbor called for welfare check because they had not seen her and she had not checked mailbox. No evidence of foul play.


Changed on 5/7/2021

VAERS ID: 974489 Before After
VAERS Form:2
Age:80.0
Sex:Female
Location:Michigan
Vaccinated:2021-01-19
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-25
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: Ipratropium and prednisone prescribed on 1/6/2021. Other medications include albuterol inhaler & nebulizer solution, calcium carbonate, cetirizine, cyclobenzaprine, fluticasone nasal spray, Advair HFA, home oxygen, guaifenesin, lidocaine 5
Current Illness: Asthma, COPD exacerbation.
Preexisting Conditions: Essential hypertension, dyslipidemia, allergic rhinitis, COPD, brain aneurysm, hiatal hernia, tobacco abuse, hyponatremia, normochromic, normocytic anemia, hx of MI, anxiety, intractable pain.
Allergies: Clarithromycin, cefaclor, ciprofloxacin, codeine, erythromycin, penicillins, tramadol, naproxen. All of these cause shortness of breath. Generic lisinopril-HCTZ caused severe headache and nausea. Statins cause joint pain and stiffness, couldn''t walk. walk.
Diagnostic Lab Data: Medical Examiner does not believe this is related to vaccine.
CDC 'Split Type':

Write-up: No immediate symptoms. No symptoms ever reported. Patient was found dead in her home on 1/25/2021 and last seen on 1/24/2021. Neighbor called for welfare check because they had not seen her and she had not checked mailbox. No evidence of foul play.


Changed on 5/21/2021

VAERS ID: 974489 Before After
VAERS Form:2
Age:80.0
Sex:Female
Location:Michigan
Vaccinated:2021-01-19
Onset:2021-01-25
Submitted:0000-00-00
Entered:2021-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-25
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: Ipratropium and prednisone prescribed on 1/6/2021. Other medications include albuterol inhaler & nebulizer solution, calcium carbonate, cetirizine, cyclobenzaprine, fluticasone nasal spray, Advair HFA, home oxygen, guaifenesin, lidocaine 5
Current Illness: Asthma, COPD exacerbation.
Preexisting Conditions: Essential hypertension, dyslipidemia, allergic rhinitis, COPD, brain aneurysm, hiatal hernia, tobacco abuse, hyponatremia, normochromic, normocytic anemia, hx of MI, anxiety, intractable pain.
Allergies: Clarithromycin, cefaclor, ciprofloxacin, codeine, erythromycin, penicillins, tramadol, naproxen. All of these cause shortness of breath. Generic lisinopril-HCTZ caused severe headache and nausea. Statins cause joint pain and stiffness, couldn''t walk. walk.
Diagnostic Lab Data: Medical Examiner does not believe this is related to vaccine.
CDC 'Split Type':

Write-up: No immediate symptoms. No symptoms ever reported. Patient was found dead in her home on 1/25/2021 and last seen on 1/24/2021. Neighbor called for welfare check because they had not seen her and she had not checked mailbox. No evidence of foul play.

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