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This is VAERS ID 935343

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History of Changes from the VAERS Wayback Machine

Color Schemes (Before/After):

First Appeared on 1/15/2021

VAERS ID: 935343
VAERS Form:2
Age:89.0
Sex:Female
Location:Kansas
Vaccinated:2021-01-08
Onset:2021-01-11
Submitted:0000-00-00
Entered:2021-01-11
Vaccin­ation / Manu­facturer (1 vaccine) Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / SYR

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-11
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:
Current Illness:
Preexisting Conditions: This resident had covid a couple months ago. she had a bad heart and also dementia. I do not believe it was the vaccine that killed her. I was instructed by EMS to report because the date of vaccination was three days ago.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: There were no adverse reactions. Resident Died, she had a history of issues with her health prior to the vaccine.

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