National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1243516

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1243516
VAERS Form:2
Age:16.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-03-19
Onset:2021-03-28
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH RT2613 / 1 UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Cardiac arrest, Circulatory collapse, Death, Pulmonary embolism, Computerised tomogram thorax abnormal, Lung assist device therapy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-30
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Oral contraceptives Sertraline Loratadine Fluticasone Doxycycline, albuterol
Current Illness: Asthma, ADHD, Anxiety
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: Bilateral PE on CT Scan
CDC 'Split Type':

Write-up: Hemodynamic collapse at home. Persistent cardiac arrest requiring ECMO. Event believed secondary to pulmonary embolism. Death by neurologic criteria.


Record is removed as of 4/30/2021

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1243516&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166