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This is VAERS ID 1037342

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1037342
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-01-17
Onset:2021-01-28
Submitted:0000-00-00
Entered:2021-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1491 / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Cardiac failure, Diet refusal, Disturbance in attention, Hypotension, Stupor, Hyporesponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-04
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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Dementia
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021146131

Write-up: Refusal to eat; Hyporesponsive to stimuli; Final decompensation/Decompensation cardiac; Generalized hypotension/Iatrogenic hypotension; Stupor; Vigilance reduction; This is a spontaneous report from a non-contactable physician downloaded from the Medicines Agency (MA) Regulatory authority-WEB DE-PEI-PEI2021002332. A 92-year-old female patient received first dose of bnt162b2 (COMIRNATY, lot number: EL1491), via an unspecified route of administration on 17Jan2021 at single dose for COVID-19 immunisation. Medical history included dementia from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. On 28Jan2021, after vaccination, the patient developed refusal to eat, hyporesponsive to stimuli, final decompensation/decompensation cardiac, generalized hypotension/iatrogenic hypotension, stupor and vigilance reduction, lasting for unknown and caused death of patient. The patient died on 04Feb2021. An autopsy was not performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: refusal to eat; hyporesponsive to stimuli; final decompensation/decompensation cardiac; generalized hypotension/iatrogenic hypotension; stupor; vigilance reduction

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