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VAERS ID: 1420630

AGE: 16| SEX: F|State: PA

Description

~4 weeks after the 2nd dose of Pfizer, patient presented to the hospital with chest pain; had pericardial effusion. Initially improved but then had decompensation, prolonged hospitalization. Diagnosed with hemophagocytic lymphohistocytosis (HLH) and ultimately died.

Symptoms

Chest pain, Death, General physical health deterioration, Haemophagocytic lymphohistiocytosis, Pericardial effusion

Vaccines

VAX DATE: 12 March 2021 | ONSET DATE: 02 April 2021 | DAYS TO ONSET: 21
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 1
  • IM
  • UN

RECVDATE:22 June 2021
CAGE_YR:16
CAGE_MO:
RPT_DATE:
DIED:Y
DATEDIED:14 June 2021
L_THREAT:
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:32
X_STAY:
DISABLE:
RECOVD:N
LAB_DATA:
V_ADMINBY:PVT
OTHER_MEDS:Artane, azithromycin, calcium carbonate, dicyclomine, doxycycline, escitalopram, flovent, gabapentin, lansoprazole, melatonin, ondansetron, tedizolid,
CUR_ILL:disseminated mycobacterium chelonae infection
HISTORY:ataxia telangiectasia; EBV-associated lymphoma
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:22 June 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:none
V_FUNDBY:
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