VAERS ID: 1774984

AGE: 16| SEX: M|STATE: LA (United States)

Description

Pediatric Multisystem Inflammatory Syndrome

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

Laboratory test, Multisystem inflammatory syndrome in children

Vaccines

VAX DATE: 07-29-2021| ONSET DATE: 08-10-2021| DAYS TO ONSET: 12
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH FA7485 IM LA

RECVDATE:10-09-2021
RPT_DATE:
CAGE_YR:16
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:1
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:Extensive labs
V_ADMINBY:PHM
OTHER_MEDS:not known
CUR_ILL:
HISTORY:Obesity (BMI 38.36)
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:10-09-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:not known
V_FUNDBY:

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