VAERS ID: 1912785

AGE: 17| SEX: F|STATE: MN (United States)

Description

Dose 1 given 4/21/2021 Pfizer Lot # EW0172 Patient had a cardiac arrest at home and was pronounced dead at Emergency Room. Covid test was negative.

Open in Wayback Machine
(If this is a foreign report without a description you will be able to read the description in the Wayback Machine on Medalerts if the report became public for the first time before November 18, 2022.)

Symptoms

Cardiac arrest, Death, SARS-CoV-2 test negative

Vaccines

VAX DATE: 05-12-2021| ONSET DATE: 05-12-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH EW0175 Unknown Unknown

RECVDATE:12-01-2021
RPT_DATE:
CAGE_YR:17
CAGE_MO:
DIED:Y
DATEDIED:11-30-2021
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:PVT
OTHER_MEDS:
CUR_ILL:
HISTORY:"complex medical history", patient had a trach and in home nursing care, no other information available at this time.
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-01-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

Questions? Comments? Bugs?
[email protected]
Due to the high volume of inquiries, please be patient with response times.

AND PLEASE read the FAQ first.

OpenVAERS is a private organization that posts publicly available CDC/FDA data of injuries reported post-vaccination. Reports are not proof of causality.