VAERS ID: 1003494

AGE: 81| SEX: M|STATE: IL (United States)

Description

Possible transverse myelitis developing 2 days after vaccine injection. Death on day 9 after vaccination

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Symptoms

Death

Vaccines

VAX DATE: 01-18-2021| ONSET DATE: 01-18-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH EK 5730 SC LA

RECVDATE:02-04-2021
RPT_DATE:
CAGE_YR:81
CAGE_MO:
DIED:Y
DATEDIED:01-27-2021
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:PVT
OTHER_MEDS:acetaminophen, 650 mg= 2 tab, Oral, q6hr, PRN amLODIPine, 10 mg= 2 tab, Oral, Daily aspirin, 81 mg= 1 tab, Chewed, Daily atorvastatin, 40 mg= 1 tab, Oral, Q Bedtime Keppra, 1000 mg= 2 tab, Oral, every 12 hr levothyroxine, 75 mcg= 1 tab
CUR_ILL:Recent hemorrhagic stroke
HISTORY:Seizure disorder, prior subdural bleed status post cranioplasty, bipolar disorder, hypertension, hyperlipidemia, and vasovagal syncope
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:02-04-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:Penicillin
V_FUNDBY:

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