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VAERS ID: 1690103

AGE: 14| SEX: M|State: FR

Description

pulmonary edema; This is a spontaneous report from a Pfizer-sponsored program, from a contactable consumer (patent's uncle) through the Pfizer company doctor. A 14-year-old male patient received bnt162b2 (COMIRNATY), 1st dose on 06Jul2021 (Lot Number: EX0893) and 2nd dose on 27Jul2021 (Lot Number: EW2246, both via an unspecified route of administration as single dose for COVID-19 immunization. Medical history none. Concomitant medications were not reported. The patient experienced pulmonary edema (death) on 03Sep2021. The patient died on 03Sep2021. The autopsy revealed that the cause of death was pulmonary edema.; Reported Cause(s) of Death: pulmonary edema

Symptoms

Pulmonary oedema

Vaccines

VAX DATE: 26 July 2021 | ONSET DATE: 02 September 2021 | DAYS TO ONSET: 38
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 2
  • EW2246

RECVDATE:09 September 2021
CAGE_YR:
CAGE_MO:
RPT_DATE:
DIED:Y
DATEDIED:02 September 2021
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:N
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
PRIOR_VAX:
SPLTTYPE:ESPFIZER INC202101170757
FORM_VERS:2
TODAYS_DATE:09 September 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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