This is VAERS ID 944439

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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	EJ1685 / 1	- / IM

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

Life Threatening? No
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)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra, Levothyroxine, Miralax, Olanzapine, Trazadone, Risperidone, and Lorazepam
Current Illness: Receiving hospice services
Preexisting Conditions: Stage 4 kidney function
Allergies: N/A
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Resident expired on 1/2/21.

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