VAERS ID: 914917

AGE: 63| SEX: M|STATE: IL (United States)

Description

Death by massive heart attack. Pfizer-BioNTech COVID-19 Vaccine EUA

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

Myocardial infarction, Death

Vaccines

VAX DATE: 12-19-2020| ONSET DATE: 12-23-2020| DAYS TO ONSET: 4
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 0 COVID19 PFIZER\BIONTECH ej1685 Unknown Unknown

RECVDATE:12-30-2020
RPT_DATE:
CAGE_YR:63
CAGE_MO:
DIED:Y
DATEDIED:12-23-2020
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:Death certificate
V_ADMINBY:WRK
OTHER_MEDS:Atenolol, Chlorthalidone, Tamsulosin
CUR_ILL:None
HISTORY:hypertension
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-30-2020
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:None
V_FUNDBY:

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