Adverse Event Reporting

VAERS ID	2173334
Gender	Male
Age	69
StateCode	OK
Pharmaceutical Company	PFIZER\BIONTECH
Lot Number
Number of vaccinations	2
Vaccinated	2021-01-29
Onset	2021-08-09
Condition	Hospitalized Died

Symptoms

• COVID-19

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Write-up

COVID-19 resulting in inpatient hospitalization" of a vaccinated patient.