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VAERS ID: 1689212

AGE: 17| SEX: M|State: TX

Description

SARS COV2 POSITIVE ON 7/20; EXPIRED 8/29/2021

Symptoms

COVID-19, Death, SARS-CoV-2 test positive

Vaccines

VAX DATE: 16 April 2021 | ONSET DATE: 19 July 2021 | DAYS TO ONSET: 94
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • UNK
  • IM

RECVDATE:09 September 2021
CAGE_YR:17
CAGE_MO:
RPT_DATE:
DIED:Y
DATEDIED:28 August 2021
L_THREAT:
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:51
X_STAY:
DISABLE:
RECOVD:N
LAB_DATA:
V_ADMINBY:PVT
OTHER_MEDS:CETIRIZINE, ERGOCALCIFEROL,
CUR_ILL:STAGE IV TESTICULAR EMBRYONAL RHABDOMYOSARCOMA W/ LUNG & BONE METASTASES
HISTORY:SEE ABOVE
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:09 September 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:VANCOMYCIN, TEMSIROLIMUS
V_FUNDBY:
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