This is VAERS ID 1890705

Administered by: Private       Purchased by: ?
Symptoms: Blood gases abnormal, Blood pH decreased, Carbon dioxide increased, Death, Intensive care, Pulse absent, Respiratory arrest, Resuscitation
SMQs:, Anaphylactic reaction (broad), Lactic acidosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-11-22
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol nebs, baclofen, vitamin D, flonase, glycopyrrolate, levetiracetam, nystatin topical, phenobarbital, Miralax, azithromycin, PRN tylenol and ibuprofen
Current Illness: Recent admission for rhino/enterovirus, mycoplasma pneumoniae ab+ for acute respiratory failure.
Preexisting Conditions: PMH of twin to twin transfusion born at erm, neuroimaging showed significant loss of gray-white matter, hydrocephalus s/p VP shunt, spastic CP, seizure disorder. Use CPAP at home at night.
Allergies: none known
Diagnostic Lab Data: Blood gas was done indicating pH<6, high CO2.
CDC Split Type:

Write-up: Due to patient''s complex PMH, provider asked that patient be monitored overnight after administration of COVID vaccine. Patient was moved from PICU to general peds floor due to improvement in condition on Thursday. Vaccine was administered that evening. Patient did well. Remained on room air. Was discharged home on Saturday. On Monday morning, father checked on patient and she was found pulseless and not breathing. It is unclear whether or not patient was placed on home CPAP during the night. EMS called. Patient arrived to ED as a CPR in progress. Patient presented with a pH of <6. Last known well 9pm the evening prior. Patient expired at 11/22/21 at 11:05 CST.