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This is VAERS ID 1505250

History of Changes from the VAERS Wayback Machine

First Appeared on 7/30/2021

VAERS ID: 1505250
VAERS Form:2
Age:13.0
Sex:Female
Location:Maryland
Vaccinated:2021-07-01
Onset:2021-07-27
Submitted:0000-00-00
Entered:2021-07-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: Blood glucose increased, Death, Full blood count, Ventricular tachycardia, Pulseless electrical activity, Metabolic function test normal, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-07-27
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: one dose of dramamine given in the evening prior to arrival.
Current Illness: none
Preexisting Conditions: none, remote history of asthma
Allergies: none
Diagnostic Lab Data: CBC, CMP normal except slightly elevated glucose COVID PCR negative
CDC 'Split Type':

Write-up: patient arrived in ventricular tachycardia via EMS, but responsive. deteoriarated to pulseless ventricular tachycardia, PEA and ultimately death.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1505250&WAYBACKHISTORY=ON

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