VAERS ID: 1056153

AGE: | SEX: F|STATE: FR (Unknown)

Description

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

Vaccination failure, Chest X-ray, Blood culture, Viral test, Septic shock, Acute respiratory failure, Pneumonia bacterial, Ultrasound chest, Respiratory viral panel, Multiple organ dysfunction syndrome, SARS-CoV-2 test, COVID-19

Vaccines

VAX DATE: 01-27-2021| ONSET DATE: 02-01-2021| DAYS TO ONSET: 5
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH EJ6797 OT

RECVDATE:02-26-2021
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:Y
DATEDIED:02-11-2021
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:EUTIROX; RETACRIT [EPOETIN ZETA]
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:02-24-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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