VAERS ID: 1909570

AGE: 33| SEX: M|STATE: NY

Description

PATIENT AND MOTHER CAME IN WEDNESDAY 11.24.21 AFTERNOON FOR COVID BOOSTER. MOTHER REPORTED TO PHARMACY ON FRIDAY 11.26.21 (DEPARTMENT CLOSED THURSDAY 11.25.21) THAT PATIENT HAD STARTED FEELING "UNWELL" (FEVER/TIREDNESS) LATE 11.24.21 / EARLY 11.25.21. MOTHER REPORTED DIDNT THINK MUCH OF IT BUT THAT HER SON (PATIENT) WAS GOING TO REST. MOTHER REPORTED THAT LATER IN THE DAY SON WENT INTO THE BATHROOM AND WAS IN THERE FOR SOME TIME, WHEN SHE WENT TO CHECK ON HIM, SHE COULD NOT GET THE DOOR OPEN. UPON OPENING THE DOOR, SON WAS FOUND UNRESPONSIVE. ATTEMPTS TO REVIVE SON BY MEDICAL PERSONEL WERE UNSUCCESSFUL. PER MOTHER AN AUTOPSY IS SCHEDULED BUT AS OF REPORTING NO CAUSE OF DEATH HAS BEEN LISTED.

Symptoms

Death, Fatigue, Malaise, Pyrexia, Resuscitation, Unresponsive to stimuli

Vaccines

VAX DATE: 11-24-2021| ONSET DATE: 11-25-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 3 COVID19 PFIZER\BIONTECH 33030BD IM LA

RECVDATE:11-30-2021
RPT_DATE:
CAGE_YR:33
CAGE_MO:
DIED:Y
DATEDIED:11-25-2021
L_THREAT:U
ER_VISIT:U
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:PHM
OTHER_MEDS:PATIENT USES local PHARMACY - PRESCRIPTION HISTORY UNKNOWN
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:11-30-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

Questions? Comments? Bugs?
[email protected]
Due to the high volume of inquiries, please be patient with response times.

AND PLEASE read the FAQ first.

OpenVAERS is a private organization that posts publicly available CDC/FDA data of injuries reported post-vaccination. Reports are not proof of causality.