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This is VAERS ID 932787

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History of Changes from the VAERS Wayback Machine

Color Schemes (Before/After):

First Appeared on 1/15/2021

VAERS ID: 932787
VAERS Form:2
Age:70.0
Sex:Female
Location:Georgia
Vaccinated:2021-01-08
Onset:2021-01-10
Submitted:0000-00-00
Entered:2021-01-10
Vaccin­ation / Manu­facturer (1 vaccine) Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 UN / IM

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

Life Threatening? No
Birth Defect? Yes
Died? Yes
   Date died:2021-01-10
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: CRANBERRY, PROZAC, NEUROTIN PERCOCET, IMMODIUM, SYNTHROID, LINZESS, LIPITOR, MELATONIN METFORMIN, PROTONIX PLAVIX, PROAIR, ropinirole, PROAIR SYMBICORT, THIAMINE TYLENOL VIT C VOLTAREN. ZANAX, ZOFRAN
Current Illness: PNEUMONIA
Preexisting Conditions: DEPRESSION CHRONIC LUNG ANEMIA
Allergies: TRAMADOL, methocarbamol
Diagnostic Lab Data: NONE AT TIME OF REPORTING, TALK OF AN AUTOPSY
CDC 'Split Type':

Write-up: RECIEVED VACCINE 1/8/21 EXPIRED UNEXPECTED 1/10/21, NO ADVERSE REACTIONS NOTED

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