VAERS ID: 1815197

AGE: 16| SEX: M|STATE: NY

Description

I experienced extreme tiredness, heart condition

Symptoms

Cardiac disorder, Fatigue

Vaccines

VAX DATE: 04-03-2021| ONSET DATE: 07-01-2021| DAYS TO ONSET: 89
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH ER8736 IM LA

RECVDATE:10-25-2021
RPT_DATE:
CAGE_YR:16
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:U
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:
V_ADMINBY:
OTHER_MEDS:
CUR_ILL:
HISTORY:Heart disease
PRIOR_VAX:
SPLTTYPE:vsafe
FORM_VERS:2
TODAYS_DATE:10-25-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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