Adverse Event Reporting
| VAERS ID | 2315524 |
|---|---|
| Gender | Male |
| Age | 74 |
| StateCode | |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | EN6198 |
| Number of vaccinations | 2 |
| Vaccinated | 2021-03-03 |
| Onset | 2021-12-01 |
| Condition | Hospitalized Died |
Symptoms
- Confusional state
- Pyrexia
- Intensive care
- Asthenia
- Myalgia
- Cough
- SARS-CoV-2 test positive
- COVID-19
- Death
Current Illness
Preexisting Conditions
leukemia, A Fib,
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Write-up
Pfizer COVID vaccine # 3 given 12/3/21, lot # 33130BA; pt presented to ED on 12/27/21 with fever, confusion and weakness; hx of cough, myalgias, weakness x 3 days; positive for COVID in ED; on O2 supplementation; given ABX, dexamethasone, remdesivir; pt did not improve; transferred to ICU where he passed away on 1/2/22