VAERS ID: 1848647

AGE: 16| SEX: M|STATE: CA

Description

High fever Vomiting Gastrointestinal problems for 2 months Always nauseated Weight loss 19 pounds Went from 135 to 114 in 2 months

Symptoms

Gastrointestinal disorder, Nausea, Pyrexia, Vomiting, Weight decreased

Vaccines

VAX DATE: 08-01-2021| ONSET DATE: 08-29-2021| DAYS TO ONSET: 28
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH SYR Unknown

RECVDATE:11-06-2021
RPT_DATE:
CAGE_YR:15
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:U
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:Y
RECOVD:N
LAB_DATA:
V_ADMINBY:PHM
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:11-06-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:Y
ALLERGIES:
V_FUNDBY:

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