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 Type | Manufacturer | Vaccine Name | Dose | Route | Site | Lot |
|---|
|
|
- COVID19 (COVID19 (PFIZER-BIONTECH))
|
|
|
|
|
- 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: