VAERS ID: 1328966

AGE: 13| SEX: M|STATE: CA (United States)

Description

?COVID arm?

Open in Wayback Machine
(If this is a foreign report without a description you will be able to read the description in the Wayback Machine on Medalerts if the report became public for the first time before November 18, 2022.)

Symptoms

Vaccination complication

Vaccines

VAX DATE: 05-13-2021| ONSET DATE: 05-17-2021| DAYS TO ONSET: 4
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EW0173 IM LA

RECVDATE:05-19-2021
RPT_DATE:
CAGE_YR:13
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:None
V_ADMINBY:OTH
OTHER_MEDS:Had taken a single dose of Dramamine on May 15th
CUR_ILL:None
HISTORY:None
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:05-19-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:Seasonal allergies
V_FUNDBY:

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