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This is VAERS ID 1386841

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/18/2021

VAERS ID: 1386841
VAERS Form:2
Age:16.0
Sex:Male
Location:Georgia
Vaccinated:2021-06-03
Onset:2021-06-07
Submitted:0000-00-00
Entered:2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK AR / IM

Administered by: Other      Purchased by: ??
Symptoms: Abdominal discomfort, Condition aggravated, Death, Headache

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-06-07
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? No
Previous Vaccinations:
Other Medications: Adderall
Current Illness: Headache, upset stomach
Preexisting Conditions: ADHD
Allergies: NKDA
Diagnostic Lab Data: Autopsy pending
CDC 'Split Type':

Write-up: Prodrome of headache and gastric upset over 2 days following second dose. Then felt fine. Found the following day dead in bed. Autopsy pending

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