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VAERS ID: 1694568

AGE: 16| SEX: F|State: WI

Description

pulmonary embolism

Symptoms

Autopsy, Pulmonary embolism

Vaccines

VAX DATE: 18 March 2021 | ONSET DATE: 27 March 2021 | DAYS TO ONSET: 9
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • UNK

RECVDATE:12 September 2021
CAGE_YR:16
CAGE_MO:
RPT_DATE:
DIED:Y
DATEDIED:29 March 2021
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:N
LAB_DATA:autopsy
V_ADMINBY:OTH
OTHER_MEDS:albuterol, Flovent, doxycycline, drospirenone and ethinyl estradiol, and Zoloft
CUR_ILL:
HISTORY:asthma
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:12 September 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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