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