VAERS ID: 930431

AGE: 89| SEX: F|STATE: CT (United States)

Description

Cardiac event, 2 days after vaccination, patient expired.

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Symptoms

Cardiac disorder, Death

Vaccines

VAX DATE: 01-06-2021| ONSET DATE: 01-08-2021| DAYS TO ONSET: 2
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EL0140 IM AR

RECVDATE:01-08-2021
RPT_DATE:
CAGE_YR:89
CAGE_MO:
DIED:Y
DATEDIED:01-08-2021
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:SEN
OTHER_MEDS:Enteric Coded Aspirin, Atenolol, Centrum Silver, Citrical, Levothyroxin, Lisinipril, Phillips Colon Health Caps, Vitamin D
CUR_ILL:none
HISTORY:Aortic Stenosis, Status post Tavr procedure, Hypothyroidism, Hypertension, Thoracogenic Scoliosis, Polymyalgia Rheumatica, Heart Valve Replacement, Hyperparathyroidism
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:01-08-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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