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VAERS ID: 1382906

AGE: 15| SEX: M|State: CA

Description

Unexplained death within 48 hours

Symptoms

Death

Vaccines

VAX DATE: 14 May 2021 | ONSET DATE: 06 June 2021 | DAYS TO ONSET: 23
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 2
  • IM
  • LA
  • EW0187

RECVDATE:
07 June 2021
CAGE_YR:
15
CAGE_MO:
RPT_DATE:
DIED:
Y
DATEDIED:
06 June 2021
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:
N
LAB_DATA:
V_ADMINBY:
OTH
OTHER_MEDS:
None known
CUR_ILL:
none noted
HISTORY:
Acne, no other conditions noted
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
2
TODAYS_DATE:
07 June 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
None noted
V_FUNDBY:
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