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This is VAERS ID 992599

History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 992599
VAERS Form:2
Age:87.0
Sex:Female
Location:California
Vaccinated:2020-12-31
Onset:2021-01-03
Submitted:0000-00-00
Entered:2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Erythema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-01-03
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: Lactobacillus Capsule MULTIVITAMINS TABLET CRANBERRY TABLET
Current Illness: COVID-19 POSITIVE 12/14/20
Preexisting Conditions: COPD, DM TYPE 2, CHF, GERD, HYPERTENSION, HYPERLIPIDEMIA
Allergies: Ciprofloxacin, Codeine, Bactrim, Lactose Intolerant
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: right arm redness


Changed on 5/7/2021

VAERS ID: 992599 Before After
VAERS Form:2
Age:87.0
Sex:Female
Location:California
Vaccinated:2020-12-31
Onset:2021-01-03
Submitted:0000-00-00
Entered:2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Erythema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-01-03
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: Lactobacillus Capsule MULTIVITAMINS TABLET CRANBERRY TABLET
Current Illness: COVID-19 POSITIVE 12/14/20
Preexisting Conditions: COPD, DM TYPE 2, CHF, GERD, HYPERTENSION, HYPERLIPIDEMIA
Allergies: Ciprofloxacin, Codeine, Bactrim, Lactose Intolerant Intolerant
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: right arm redness


Changed on 5/14/2021

VAERS ID: 992599 Before After
VAERS Form:2
Age:87.0
Sex:Female
Location:California
Vaccinated:2020-12-31
Onset:2021-01-03
Submitted:0000-00-00
Entered:2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0142 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Erythema

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-01-03
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: Lactobacillus Capsule MULTIVITAMINS TABLET CRANBERRY TABLET
Current Illness: COVID-19 POSITIVE 12/14/20
Preexisting Conditions: COPD, DM TYPE 2, CHF, GERD, HYPERTENSION, HYPERLIPIDEMIA
Allergies: Ciprofloxacin, Codeine, Bactrim, Lactose Intolerant Intolerant
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: right arm redness

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=992599&WAYBACKHISTORY=ON


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