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| History of Changes from the VAERS Wayback Machine |
| VAERS ID: | 1383620 |
| VAERS Form: | 2 |
| Age: | 15.0 |
| Sex: | Male |
| Location: | California |
| Vaccinated: | 2021-06-05 |
| Onset: | 2021-06-06 |
| Submitted: | 0000-00-00 |
| Entered: | 2021-06-08 |
| Vaccination / Manufacturer | Lot / Dose | Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH | EW0187 / 2 | LA / IM |
Administered by: Private Purchased by: ??
Symptoms: Death, Sudden death
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2021-06-06
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC 'Split Type':
Write-up: Sudden death one day after recieving 2nd dose of Pfizer Covid Vaccine (6/6/21). Found dead.
Link To This Search Result:
https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1383620&WAYBACKHISTORY=ON
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