VAERS ID: 1382906

AGE: 15| SEX: M|State: CA

Description

Unexplained death within 48 hours

Symptoms

Death

Vaccines

VAX DATE: 15 May 2021 | ONSET DATE: 07 June 2021 | DAYS TO ONSET: 23
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))

        RECVDATE:
        08 June 2021
        CAGE_YR:
        15
        CAGE_MO:
        RPT_DATE:
        DIED:
        Y
        DATEDIED:
        07 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:
        08 June 2021
        BIRTH_DEFECT:
        OFC_VISIT:
        ER_ED_VISIT:
        ALLERGIES:
        None noted
        V_FUNDBY: