VAERS ID: 1053626

AGE: | SEX: M|STATE: FR (Unknown)

Description

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

Electroencephalogram abnormal, Bradycardia, Myalgia, Dyspnoea, Speech disorder, Pain, Asthenia, Cardiac arrest, Hypothermia, Atrioventricular block, Anaemia, Atelectasis, Diplopia, Thrombocytopenia, Atrial fibrillation, Dysarthria, Respiratory distress, Fatigue, Antibody test, Pneumonia aspiration, Chest discomfort, Tachypnoea, Lumbar puncture, Computerised tomogram, Electroencephalogram, Blood culture, Liver function test, Nervous system disorder, Lymphopenia, Cardio-respiratory arrest, Bradyphrenia, Parkinsonism, Computerised tomogram head, Resuscitation, Viral test, Haemoglobin, Blood thyroid stimulating hormone, Neutrophil count, C-reactive protein, CSF cell count, Blood cholesterol, Angiogram, Platelet count, Sinus disorder, Monocyte count, Eosinophil count, Vitamin B12, Blood creatinine, Lymphocyte count, Blood folate, General physical health deterioration, Blood potassium, Bacterial test, High density lipoprotein, Low density lipoprotein, Electrophoresis protein, Blood sodium, Blood triglycerides, Basophil count, Pneumonia moraxella, Investigation, Blood pressure measurement, Normocytic anaemia, Magnetic resonance imaging brain, SARS-CoV-2 test, Tracheal aspirate culture, Hypervitaminosis B12

Vaccines

VAX DATE: 01-13-2021| ONSET DATE: 01-14-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 0 COVID19 PFIZER\BIONTECH EM0477 OT LA

RECVDATE:02-25-2021
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:Y
DATEDIED:02-11-2021
L_THREAT:Y
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:TRIMEBUTINE PFIZER; BROMAZEPAM TEVA; ALFUZOSINE EG; PRAVASTATIN ACCORD; LUMIGAN; MACROGOL; LARMABAK
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:02-24-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:
V_FUNDBY:

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