|
National Vaccine Information Center Your Health. Your Family. Your Choice. |
MedAlerts.org |
History of Changes from the VAERS Wayback Machine |
VAERS ID: | 1242573 |
VAERS Form: | 2 |
Age: | 15.0 |
Sex: | Male |
Location: | Colorado |
Vaccinated: | 2021-04-18 |
Onset: | 2021-04-19 |
Submitted: | 0000-00-00 |
Entered: | 2021-04-22 |
Vaccination / Manufacturer (1 vaccine) | Lot / Dose | Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | - / 1 | RA / IM |
Administered by: Public Purchased by: ??
Symptoms: Cardiac failure, Death
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2021-04-20
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vaccinated with Pfizer/Biontech, died 04/20/2021, 2 days after vaccination
Current Illness: No
Preexisting Conditions: No
Allergies: Nothing
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Heart failure
Copyright © 2024 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166