Adverse Event Reporting
| VAERS ID | 914805 |
|---|---|
| Gender | Male |
| Age | 63 |
| StateCode | IL |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | EH9899 |
| Number of vaccinations | 1 |
| Vaccinated | 2020-12-28 |
| Onset | 2020-12-29 |
| Condition | Died |
Symptoms
- Death
Current Illness
none
Preexisting Conditions
dysphagia, violent behaviors, depressive disorder, schizophrenia, aspiration, gerd, hyperlipidemia, dipolar, rectal bleeding, HTN
Other Medications
Asa-81mg, Lisinopril 10mg daily, ferrous sulfate-325, MVI with min, zyprexia-20mg, Flomax-0.4, famotidine-20mg, vit C, carbamazepine-250mg bid, Depakote-750mg bid, metformin-1000 bid, sertraline-100 bid, albuterol,buspar-10mg TID, Fibercon-
Previous Vaccinations
Allergies
NKA
Laboratory Data
Write-up
RESIDENT CODED AND EXPIRED