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VAERS ID: 1757635

AGE: 16| SEX: F|State: TX

Description

fatigue then death

Symptoms

Death, Fatigue

Vaccines

VAX DATE: 01 October 2021 | ONSET DATE: 02 October 2021 | DAYS TO ONSET: 1
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 2
  • SYR

RECVDATE:03 October 2021
CAGE_YR:16
CAGE_MO:
RPT_DATE:
DIED:Y
DATEDIED:02 October 2021
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:N
LAB_DATA:
V_ADMINBY:PHM
OTHER_MEDS:unknown
CUR_ILL:unknown
HISTORY:none
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:03 October 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:unknown
V_FUNDBY:
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