VAERS ID: 1002808

AGE: 90| SEX: F|STATE: WV (United States)

Description

According to medical report, Pt presented to the ED on 1/14/21 w/ cc of SOB for 1 day. She received her COVID-19 vaccine on 1/9/21. Pt stated that she developed a dry hacking cough 2 days prior to the vaccine on 1/7/21. Over the last few days prior to admission, she developed generalized weakness, SOB, loss of sense of taste and smell w/ associated decreased appetite and nausea ultimately SOB in the24 hours prior to admission. Final Diagnosis- acute hypoxic respiratory failure secondary to COVID-19 pneumonia. Pt died on 2/3/21. See Medical report for more information.

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Symptoms

Dyspnoea, Nausea, Asthenia, Ageusia, Decreased appetite, Respiratory failure, Death, Anosmia, Acute respiratory failure, COVID-19 pneumonia

Vaccines

VAX DATE: 01-09-2021| ONSET DATE: 02-03-2021| DAYS TO ONSET: 25
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 0 COVID19 PFIZER\BIONTECH EL1284 IM UN

RECVDATE:02-04-2021
RPT_DATE:
CAGE_YR:90
CAGE_MO:
DIED:Y
DATEDIED:02-03-2021
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:20
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:unknown
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:Diabetes, hypertension
HISTORY:IBS, GERD, overweight, scoliosis, Macular degeneration, sciatica, umbilical hernia, RBBB, Others listed
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:02-04-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:
V_FUNDBY:

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