VAERS ID: 2194347

AGE: 5| SEX: F|STATE: NJ (United States)

Description

Patient hospitalized and diagnosed with MIS-C

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

Multisystem inflammatory syndrome in children

Vaccines

VAX DATE: 12-27-2021| ONSET DATE: 03-06-2022| DAYS TO ONSET: 69
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH fk618 UN UN

RECVDATE:03-23-2022
RPT_DATE:
CAGE_YR:5
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:6
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:
V_ADMINBY:PUB
OTHER_MEDS:
CUR_ILL:None noted
HISTORY:History of Kawasaki disease X2, 2018/2020
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:03-23-2022
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:NKA
V_FUNDBY:

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