VAERS ID: 1199455

AGE: 17| SEX: F|STATE: (United States)

Description

Patient reported difficulty breathing and chest pain; suffered cardiac arrest and death

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

Dyspnoea, Chest pain, Cardiac arrest, Death

Vaccines

VAX DATE: 04-02-2021| ONSET DATE: 04-10-2021| DAYS TO ONSET: 8
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) Unknown COVID19 PFIZER\BIONTECH Unknown Unknown

RECVDATE:04-12-2021
RPT_DATE:
CAGE_YR:17
CAGE_MO:
DIED:Y
DATEDIED:04-10-2021
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:PVT
OTHER_MEDS:fluoxetine, fesoterodine, ortho-tricyclen, oxybutynin
CUR_ILL:NA
HISTORY:spina bifida, spinal meningocele, VP shunt, scoliosis, neurogenic bladder, constipation
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:04-12-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:bananas, cephalexin, kiwi, mango, pineapple, latex
V_FUNDBY:

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