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VAERS ID: 1420762

AGE: 17| SEX: F|STATE: Unk

Description

Cardiac arrest without resuscitation. Unknown cause of cardiac arrest. Awaiting autopsy report.

Symptoms

Autopsy, Cardiac arrest

Vaccines

VAX DATE: 16 June 2021 | ONSET DATE: 22 June 2021 | DAYS TO ONSET: 6
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • UNK

RECVDATE:22 June 2021
CAGE_YR:17
CAGE_MO:
RPT_DATE:
DIED:Y
DATEDIED:22 June 2021
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:N
LAB_DATA:
V_ADMINBY:PVT
OTHER_MEDS:Vienva 0.1-20 mg-mcg per tablet
CUR_ILL:No.
HISTORY:Obesity, Family history of clotting disorder (her workup with negative), and depression.
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:22 June 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:Y
ALLERGIES:NKDA
V_FUNDBY:
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