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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 930912 |
VAERS Form: | 2 |
Age: | 73.0 |
Sex: | Male |
Location: | New York |
Vaccinated: | 2021-01-07 |
Onset: | 2021-01-08 |
Submitted: | 0000-00-00 |
Entered: | 2021-01-09 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | - / UNK | UN / UN |
Administered by: Unknown Purchased by: ??
Symptoms: Death, Diarrhoea
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2001-01-08
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Diarrhea followed by death 24 hrs after vaccination
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