This is VAERS ID 930431

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 1/15/2021

Vaccin­ation / Manu­facturer (1 vaccine)	Lot / Dose	Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH	EL0140 / 1	AR / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Death, Cardiac disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-08
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: Enteric Coded Aspirin, Atenolol, Centrum Silver, Citrical, Levothyroxin, Lisinipril, Phillips Colon Health Caps, Vitamin D
Current Illness: none
Preexisting Conditions: Aortic Stenosis, Status post Tavr procedure, Hypothyroidism, Hypertension, Thoracogenic Scoliosis, Polymyalgia Rheumatica, Heart Valve Replacement, Hyperparathyroidism
Allergies: None
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Cardiac event, 2 days after vaccination, patient expired.

New Search