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This is VAERS ID 1536271

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History of Changes from the VAERS Wayback Machine

First Appeared on 8/13/2021

VAERS ID: 1536271
VAERS Form:2
Age:76.0
Sex:Male
Location:Tennessee
Vaccinated:2021-02-26
Onset:2021-08-06
Submitted:0000-00-00
Entered:2021-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 AR / IM

Administered by: Public      Purchased by: ??
Symptoms: Death, COVID-19 pneumonia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-08-06
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? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN, CAD
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. passed from COVID19 Pneumonia on 8/6/2021

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