VAERS ID: 914604

AGE: 74| SEX: M|STATE: MI (United States)

Description

Spouse awoke 12/20 and found spouse dead. Client was not transferred to hospital.

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

Death

Vaccines

VAX DATE: 12-16-2020| ONSET DATE: 12-20-2020| DAYS TO ONSET: 4
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EH9899 IM

RECVDATE:12-30-2020
RPT_DATE:
CAGE_YR:74
CAGE_MO:
DIED:Y
DATEDIED:12-20-2020
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-21-2020
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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