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))

        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: