Adverse Event Reporting
| VAERS ID | 1910053 |
|---|---|
| Gender | Male |
| Age | 59 |
| StateCode | IL |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | 32020BD |
| Number of vaccinations | 3 |
| Vaccinated | 2021-10-27 |
| Onset | 2021-11-22 |
| Condition | Hospitalized Life Threatening Died |
Symptoms
- Intensive care
- Hypotension
- Respiratory rate increased
- Oxygen saturation decreased
- Pneumonia
- Sepsis
- Death
- Pulmonary thrombosis
Current Illness
Preexisting Conditions
Type 1 Diabetes
Other Medications
Insulin for Type 1 Diabetes
Previous Vaccinations
Allergies
Laboratory Data
Write-up
Double pneumonia with blood clots in lungs.
Sepsis.
Extremely low oxygen levels in blood.
Extremely low blood pressure.
Rapid breathing - over 60 per minute.
5-day ICU stay at Hospital.
Death.