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From the 10/15/2021 release of VAERS data:

Found 2,281 cases where Vaccine is COVID19 and Symptom is COVID-19 and Patient Died



Case Details (Sorted by Age)

This is page 3 out of 229

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VAERS ID: 1429416 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-26
Onset:2021-04-01
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Death, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: Covid-19; Result Unstructured Data: Test Result:Contracted COVID
CDC Split Type: USPFIZER INC2021694061

Write-up: Contracted COVID in April before they could receive the 2nd dose and were hospitalized for 2 weeks; Contracted COVID in April before they could receive the 2nd dose and were hospitalized for 2 weeks; Husband passed away; This is a spontaneous report from a contactable pharmacist. This pharmacist (Patient''s wife) reported for a male patient (Reporter''s husband). A 70-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection. Lot number: unknown), dose 1 via an unspecified route of administration on 26Mar2021 as dose 1, single for COVID-19 immunization. No medical and concomitant medication history were reported. She and her husband (who also received the vaccine) contracted COVID in April 2021 before they could receive the second dose and were hospitalized for 2 weeks. The husband passed away on an unspecified date, while the patient recovered from a severe (not mild) COVID infection. She was asking if she can get the second dose and when should she receive the second dose.The patient underwent lab tests and procedures which included SARS-CoV-2 test contracted COVID-19 in Apr2021.It was not reported if an autopsy was performed. The outcome of the event death was fatal and rest on events was unknown. information about lot/batch number has been requested.; Sender''s Comments: As there is limited information in the case provided, the causal association between the event and the suspect drug cannot be excluded. The case will be reassessed once new information is available. The impact of this report on the benefit/risk profile of the Pfizer drug is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: husband passed away


VAERS ID: 1456646 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-03
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Antibody test, COVID-19, Coombs test, Death, SARS-CoV-2 antibody test negative
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hodgkin''s disease (and they took his spleen out so he is a little immunocompromised.)
Allergies:
Diagnostic Lab Data: Test Date: 20210407; Test Name: IG; Test Result: Negative ; Comments: AbIG Quantitative; Test Date: 20210524; Test Name: IG; Test Result: Negative ; Comments: IGg; Test Date: 2021; Test Name: IG; Test Result: Negative ; Comments: IGgAb, ABIGm; Test Date: 20210407; Test Name: COB TEST; Test Result: Negative ; Test Date: 20210524; Test Name: COB TEST; Test Result: Negative ; Test Date: 2021; Test Name: COB TEST; Test Result: Negative ; Test Date: 20210407; Test Name: COVID-19 test; Test Result: Negative ; Test Date: 20210524; Test Name: COVID-19 test; Test Result: Negative ; Test Date: 20210407; Test Name: SARS test; Test Result: Negative ; Test Date: 20210524; Test Name: SARS test; Test Result: Negative ; Test Date: 2021; Test Name: SARS test; Test Result: Negative
CDC Split Type: USPFIZER INC2021640296

Write-up: passed away; The initial case was missing the following minimum criteria: adverse event. Upon receipt of follow-up information on 01Jul2021, this case now contains all required information to be considered valid. This is a spontaneous report from a contactable consumer (patient) and patient''s wife. A 69-years-old male patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EN6201), via an unspecified route on 10Feb2021 (at the age of 69-years) as dose 1, single and second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EN6203), via an unspecified route on 03Mar2021 (at the age of 69-years) as dose 2, single for covid-19 immunisation. The patient medical history included Hodgkin''s disease from 1978 (they took his spleen out, so he was a little immunocompromised and they took out his spleen and appendix after diagnosis) and unknown if ongoing. The patient concomitant medications were not reported. On unspecified date, the patient experienced had 3 antibody tests- one that was a 15minutes finger prick and two others that were all 2-3 weeks apart. Patient stated all 3 tests were negative for antibodies and his doctors don''t know why. His doctors said maybe it did not detect antibodies to the vaccine. In 1978, he had Hodgkin''s disease and they took his spleen out, so he was a little immunocompromised. However, the infectious disease doctor said since he got both doses he should still be protected. Reporter was concerned that he didn''t had great immune system when three negative tests came back, he just want to make sure that everybody thinks he was not okay because he was going out over usual instructions because of them. His primary care physician (PCP) said he talked to another doctor and said if he had the vaccine it should be covered but the test came back negative. Reporter stated that the "last test he had was on 24May2021, it was COVID-19 antibody test, SARS test, COB test 2, AbIG Quantitative. This one was done on maybe 10th (unspecified date in 2021) it was rapid test for SARS, COB-2, IGg antibody. That was done on 07Apr201 and stated if Pfizer want, he can give that also, SARS, COVID, COB-2, IGgAb, AbIGm, they all came back negative". Patient''s wife stated her husband passed away and at the time of the vaccination she and her daughter got adverse reactions she would like to fill the form for both her and her daughter. The patient died on unspecified date in 2021 with unknown cause of death and autopsy results was unknown. The outcome of the event was fatal. Follow up needed, further information has been requested.; Reported Cause(s) of Death: passed away


VAERS ID: 1493247 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: South Carolina  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Antibody test, COVID-19, Cough, Drug ineffective, Dyspnoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-10
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Bypass surgery (She had bypass 19 years ago); COPD
Allergies:
Diagnostic Lab Data: Test Name: Antibody Test; Result Unstructured Data: Test Result:no antibody at all; Test Date: 2021; Test Name: Covid-19; Test Result: Positive ; Comments: She caught Covid and died.
CDC Split Type: USPFIZER INC2021881403

Write-up: My mother in law received the vaccine 4-5 months ago. She caught Covid and died; My mother in law received the vaccine 4-5 months ago. She caught Covid and died; Just couldn''t breathe; A little cough; This is a spontaneous report received from a contactable consumer via Pfizer sponsored program. The caller is calling on behalf of her deceased Mother-in-law. A 73-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Batch/Lot number was not reported, Expiration Date: Unknown), via an unspecified route of administration on an unspecified date as dose number unknown, single for COVID-19 immunization. Medical history included COPD from an unknown date and unknown if ongoing, Bypass (She had bypass 19 years ago) from an unknown date and unknown if ongoing. The reporter stated that " I don''t know what else was she taking." The patient''s concomitant medications were not reported. Reporter wants to know if Pfizer was giving a placebo or the actual vaccine. She believes her mother-in-law had received a placebo vaccine. My mother-in-law received the vaccine 4-5 months ago. She caught Covid and died (2021). The doctor confirmed she did not have any antibodies. We all had been exposed to her. We are currently in quarantine. My father-in-law is 80 years old and was nervous. He was wondering why did he take the vaccine if it did not protect his wife or him. Reported doctor had basically tested her and they had found no antibodies. At the moment she was nervous because her father-in-law lived with them and they were both quarantined and he was 80 years old. Reporter stated they said she had no antibodies like she never got the vaccine. Reporter stated I do not know the name of antibody Test, but the hospital did it and they said she had no antibody at all. Date of Death: Reporter stated, I am not sure my father-in-law did knows exactly when they got vaccinated but it was 3 or 5 months ago. Reporter stated, "No, she went to the hospital on Thursday evening, and she had been on the ventilator like 3 hours later and she died on Saturday morning 2 O''clock. She had no fever, she had a little cough not major stuff, it was like flu the fever and usual cough she did not had any of that. She had no flu, she just couldn''t breathe (2021). Anatomical Site of Administration: Reporter stated, I just know that she received it 4 months ago. The patient underwent lab tests and procedures which included antibody test: no antibody at all, Covid-19: positive on 2021 (She caught Covid and died). Therapeutic measures were taken as a result of my mother in law received the vaccine 4-5 months ago. she caught covid and died, just couldn''t breathe. The patient died on 10Jul2021. An autopsy was not performed. The outcome of events just couldn''t breathe and cough was unknown, while other events was fatal. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: My mother in law received the vaccine 4-5 months ago. She caught Covid and died


VAERS ID: 1524928 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Tennessee  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body mass index, Body mass index abnormal, COVID-19, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: BMI; Result Unstructured Data: Test Result:greater than 40; Test Name: COVID test; Result Unstructured Data: Test Result:Died of COVID
CDC Split Type: USPFIZER INC202100958483

Write-up: Died of COVID; Died of COVID; BMI greater than 40; This is a spontaneous report received from a contactable physician communicated to a sales representative. A 23-year-old female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for Injection), first dose as dose 1 single and second dose as dose 2 single, both via an unspecified route of administration on an unspecified date for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. Event took place after use of product. The patient experienced died of COVID, BMI greater than 40 on an unspecified date. The events drug ineffective and covid-19 assessed as serious (death, medically significant) and while for other was non-serious. The patient underwent lab tests and procedures which included body mass index: greater than 40, COVID test: died of covid on unspecified date. The patient died on an unspecified date. It was not reported if an autopsy was performed. The outcome of the events drug ineffective and covid-19 was reported as fatal and while for other was unknown. Reporter does not wish to be contacted for follow-up. No follow-up attempts are possible, information about lot/batch number cannot be obtained.; Sender''s Comments: (Based on plausible dose -event relationship post vaccination and no other alternate explanation the causal role of BNT162B2 cannot be excluded for the reported LOE events) The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.; Reported Cause(s) of Death: Died of COVID; Died of COVID


VAERS ID: 1531269 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-01
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210808115

Write-up: CONFIRMED COVID-19 INFECTION; SUSPECTED VACCINATION FAILURE; This spontaneous report received from a patient concerned a male of unspecified age, race and ethnicity unknown. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose not reported, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. It was reported that on an unspecified date, the patient experienced confirmed covid-19 infection, suspected Vaccination Failure. On an unspecified date in Jul-2021, the patient died from confirmed covid-19 infection. It was unknown if an autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of Suspected Vaccination Failure was not reported. This report was serious (Death).; Sender''s Comments: V0-20210808115-covid-19 vaccine ad26.cov2.s-Confirmed COVID-19 infection. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). 20210808115-covid-19 vaccine ad26.cov2.s-Suspected Vaccine failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: CONFIRMED COVID-19 INFECTION


VAERS ID: 1645045 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:2021-04-01
Onset:2021-07-13
   Days after vaccination:103
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Malaise
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-05
   Days after onset: 23
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: feeling sick; COVID-19; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (COVID-19) and MALAISE (feeling sick) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. In April 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In May 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 13-Jul-2021, the patient experienced MALAISE (feeling sick) (seriousness criteria death and hospitalization). On an unknown date, the patient experienced COVID-19 (COVID-19) (seriousness criterion death). The patient died on 05-Aug-2021. The reported cause of death was Covid-19. It is unknown if an autopsy was performed. Concomitant product use was not provided by the reporter. Treatment medication was not provided by the reporter. Patient started feeling sick on 13 Jul 2021 and was hospitalized a few days later. Patient was passed away on 05 Aug 2021 with a cause of Death of COVID-19. Very limited information regarding this event/s has been provided at this time. Further information has been requested. The causality for the event Covid-19 will be considered as "Not Applicable".; Sender''s Comments: Very limited information regarding this event/s has been provided at this time. Further information has been requested. The causality for the event Covid-19 will be considered as "Not Applicable"; Reported Cause(s) of Death: COVID-19


VAERS ID: 1646782 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-06
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101022590

Write-up: Her aunt just had the Pfizer Covid vaccine but ended up getting the delta variant then died; Her aunt just had the Pfizer Covid vaccine but ended up getting the delta variant then died; This is a spontaneous report from a Pfizer-sponsored program. A contactable consumer reported for a female patient (aunt) of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The medical history and concomitant medications were not reported. The consumer reported her aunt just had the PFIZER covid vaccine but ended up getting the delta variant then died. The patient died on 06Aug2021. It was not reported if an autopsy was performed. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: Her aunt just had the Pfizer Covid vaccine but ended up getting the delta variant then died; Her aunt just had the Pfizer Covid vaccine but ended up getting the delta variant then died


VAERS ID: 1647160 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Virginia  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101042649

Write-up: passed away from the Delta Variant; passed away from the Delta Variant; This is a spontaneous report from a contactable consumer (relative) from a Pfizer-sponsored program . A male patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) dose 1 and 2 via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient daughter had just received an email from Pfizer stating that the patient should come in for a third dose to cover for the Delta Variant. The patient passed away from the Delta Variant on an unspecified date. The patient died on an unspecified date. It was not reported if an autopsy was performed. The lot number for BNT162B2 was not provided and will be requested during follow up.; Reported Cause(s) of Death: passed away from the Delta Variant; passed away from the Delta Variant


VAERS ID: 1647379 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-07-01
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-18
   Days after onset: 48
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Overweight (but she was not big).
Allergies:
Diagnostic Lab Data: Test Date: 202107; Test Name: Covid-19 test; Test Result: Positive; Test Date: 20210725; Test Name: Covid-19 test; Test Result: Negative.
CDC Split Type: USPFIZER INC202101070355

Write-up: passed away of COVID19; passed away of COVID19; This is a spontaneous report from a contactable consumer (patient''s son). A 53-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for covid-19 immunisation. Medical history included a little overweight but she was not big. The patient''s concomitant medications were not reported. The patient had the COVID vaccine and she recently passed away of COVID19. Patient got tested for Covid-19 on 25Jul2021 and was negative at that time. But then 3 days to 4 days later (Jul2021) she was sick and he had to call the ambulance, that was on a Monday going into Tuesday morning, 27Jul2021 or so and she was admitted to the hospital with COVID. Then 3 days later patient stopped texting and answering and she passed away on 18Aug2021. Covid-19 tested positive in Jul2021. Reporter seriousness for COVID-19 was death. The outcome of the events was fatal. The patient died on 18Aug2021. It was not reported if an autopsy was performed. The lot number for BNT162b2 was not provided and will be requested during follow up.; Reported Cause(s) of Death: passed away of COVID19; passed away of COVID19


VAERS ID: 1647415 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101082857

Write-up: fully vaccinated father died from COVID-19 / lack of efficacy; fully vaccinated father died from COVID-19 / lack of efficacy; This is a spontaneous report from a non-contactable consumer. This consumer reported for an adult male patient received bnt162b2 (COVID-19 vaccine), dose 2 via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose, dose 1 via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The medical history and concomitant medications were not reported. The patient experienced lack of efficacy. The reporter''s fully vaccinated father died from COVID-19. The patient died on an unspecified date. It was not reported if an autopsy was performed. Doctors said the condition of the father could have been worse if he was not vaccinated at all. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: fully vaccinated father died from COVID-19 / lack of efficacy; fully vaccinated father died from COVID-19 / lack of efficacy


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