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This is VAERS ID 1757635

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1757635
VAERS Form:2
Age:16.0
Sex:Female
Location:Texas
Vaccinated:2021-10-02
Onset:2021-10-03
Submitted:0000-00-00
Entered:2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Death, Fatigue

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-10-03
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: unknown
Current Illness: unknown
Preexisting Conditions: none
Allergies: unknown
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: fatigue then death

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