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VAERS ID: 2177682

AGE: 14| SEX: M|State: AR

Description

hospitalization; covid positive fully vaccinated

Symptoms

COVID-19, SARS-CoV-2 test positive

Vaccines

VAX DATE: 07 August 2021 | ONSET DATE: 09 March 2022 | DAYS TO ONSET: 214
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 2
  • IM
  • RA
  • FC3180

RECVDATE:13 March 2022
CAGE_YR:14
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:U
LAB_DATA:positive covid antigen test 3/9/22
V_ADMINBY:PVT
OTHER_MEDS:unknown
CUR_ILL:unknown
HISTORY:unknown
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:13 March 2022
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:amoxicillin
V_FUNDBY:
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