VAERS ID: 914961

AGE: 88| SEX: F|STATE: KY (United States)

Description

pt passed away with an hour to hour and 1/2 of receiving vaccine. per nursing home staff they did not expect pt to make it many more days. pt was unresponsive in room when shot was given. per nursing home staff pt was 14 + days post covid

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Symptoms

Death

Vaccines

VAX DATE: 12-30-2020| ONSET DATE: 12-30-2020| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH el0142 Unknown LA

RECVDATE:12-30-2020
RPT_DATE:
CAGE_YR:88
CAGE_MO:
DIED:Y
DATEDIED:12-30-2020
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:SEN
OTHER_MEDS:
CUR_ILL:per nursing home staff over 14 days post covid
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-30-2020
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:none listed
V_FUNDBY:

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