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This is VAERS ID 992734

History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 992734
VAERS Form:2
Age:86.0
Sex:Female
Location:Kentucky
Vaccinated:2021-01-07
Onset:2021-01-24
Submitted:0000-00-00
Entered:2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Chest X-ray, Death, Oxygen saturation decreased, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-27
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: alendronate sodium 70 mg 1 time a day every sunday for arthritis aspirin 81 mg q day Buspirone HCL 5 mg 3 times daily Calcitonin solution 200 units 1 spray via nostril Calcium capsule 250 mg 2 times per day Cardedilol 6.25 tab 2 times per
Current Illness: Rheumatoid Arthritis, overactive bladder, glaucoma, major depressive disorder, Alzheimers Disease, polyneuropathy,
Preexisting Conditions: Rheumatoid Arthritis, overactive bladder, glaucoma, major depressive disorder, Alzheimers Disease, polyneuropathy,
Allergies: codeine, penicillin, enbrel, septra, sulfa antibiotics
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1st COVID immunization 1/7/2021, COIVD positive results on 1/16/21, 1/24/21 O2 sats decreased to 78%, 1/24/21 reveived the Bamlanivimab infusion 50 ml/hr. 1/24/20 chest x ray 1/24/21 She was sent to hospital and admitted. 1/27/2021 Expired


Changed on 5/7/2021

VAERS ID: 992734 Before After
VAERS Form:2
Age:86.0
Sex:Female
Location:Kentucky
Vaccinated:2021-01-07
Onset:2021-01-24
Submitted:0000-00-00
Entered:2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Chest X-ray, Death, Oxygen saturation decreased, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-27
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: alendronate sodium 70 mg 1 time a day every sunday for arthritis aspirin 81 mg q day Buspirone HCL 5 mg 3 times daily Calcitonin solution 200 units 1 spray via nostril Calcium capsule 250 mg 2 times per day Cardedilol 6.25 tab 2 times per
Current Illness: Rheumatoid Arthritis, overactive bladder, glaucoma, major depressive disorder, Alzheimers Disease, polyneuropathy,
Preexisting Conditions: Rheumatoid Arthritis, overactive bladder, glaucoma, major depressive disorder, Alzheimers Disease, polyneuropathy,
Allergies: codeine, penicillin, enbrel, septra, sulfa antibiotics antibiotics
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1st COVID immunization 1/7/2021, COIVD positive results on 1/16/21, 1/24/21 O2 sats decreased to 78%, 1/24/21 reveived the Bamlanivimab infusion 50 ml/hr. 1/24/20 chest x ray 1/24/21 She was sent to hospital and admitted. 1/27/2021 Expired


Changed on 5/14/2021

VAERS ID: 992734 Before After
VAERS Form:2
Age:86.0
Sex:Female
Location:Kentucky
Vaccinated:2021-01-07
Onset:2021-01-24
Submitted:0000-00-00
Entered:2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Chest X-ray, Death, Oxygen saturation decreased, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-27
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: alendronate sodium 70 mg 1 time a day every sunday for arthritis aspirin 81 mg q day Buspirone HCL 5 mg 3 times daily Calcitonin solution 200 units 1 spray via nostril Calcium capsule 250 mg 2 times per day Cardedilol 6.25 tab 2 times per
Current Illness: Rheumatoid Arthritis, overactive bladder, glaucoma, major depressive disorder, Alzheimers Disease, polyneuropathy,
Preexisting Conditions: Rheumatoid Arthritis, overactive bladder, glaucoma, major depressive disorder, Alzheimers Disease, polyneuropathy,
Allergies: codeine, penicillin, enbrel, septra, sulfa antibiotics antibiotics
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1st COVID immunization 1/7/2021, COIVD positive results on 1/16/21, 1/24/21 O2 sats decreased to 78%, 1/24/21 reveived the Bamlanivimab infusion 50 ml/hr. 1/24/20 chest x ray 1/24/21 She was sent to hospital and admitted. 1/27/2021 Expired

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=992734&WAYBACKHISTORY=ON

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