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This is VAERS ID 1784945

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1784945
VAERS Form:2
Age:12.0
Sex:Female
Location:South Carolina
Vaccinated:2021-07-11
Onset:2021-08-02
Submitted:0000-00-00
Entered:2021-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 1 UN / SYR

Administered by: Private      Purchased by: ??
Symptoms: Death, Respiratory tract haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-08-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Trisomy 18, Scoliosis, Closed Ventricular Septal Defect, Ectopic Kidney, Gastrostomy Tube dependent, GERD, and Obstructive Sleep Apnea
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Blood in airway, Death

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