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))

        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: