VAERS ID: 989015

AGE: 69| SEX: M|STATE: CT

Description

Myocardial Infarction

Symptoms

Myocardial infarction

Vaccines

VAX DATE: 01-26-2021| ONSET DATE: 01-27-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH EL9261 IM Unknown

RECVDATE:01-31-2021
RPT_DATE:
CAGE_YR:69
CAGE_MO:
DIED:Y
DATEDIED:01-27-2021
L_THREAT:U
ER_VISIT:U
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:SEN
OTHER_MEDS:
CUR_ILL:
HISTORY:End Stage Renal Disease, NON ST Elevation (NSTEM) Myocardial Infarction,, Type II Diabetes Mellitus, Cardiac Arrest cause unspecified, Paroxysmal atrial fibrillation, acute embolism and thrombosis of unspecified deep veins of right lower extremity, Alzheimer's disease, Chronis systolic heart failure,
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:01-31-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:No known allergies
V_FUNDBY:

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