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This is VAERS ID 1039724

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1039724
VAERS Form:2
Age:33.0
Sex:Unknown
Location:Foreign
Vaccinated:2021-02-10
Onset:2021-02-10
Submitted:0000-00-00
Entered:2021-02-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NOT KNOWN / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Death

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-02-10
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GBPFIZER INC2021155158

Write-up: Found dead; This is a spontaneous report from a contactable consumer. This is a report received from the RA. Regulatory authority report number GB-MHRA-WEBCOVID-202102130938244340, Safety Report Unique Identifier GB-MHRA-ADR 24753885. A 33-year-old patient of an unspecified gender received the first dose of bnt162b2 (Pfizer-Biontech Covid-19 Vaccine), via an unspecified route of administration on 10Feb2021 at single dose for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. Patient has not had symptoms associated with COVID-19. Not had a COVID-19 test. Patient was not enrolled in clinical trial. The patient died (found dead) on 10Feb2021. It was not reported if an autopsy was performed. Patient had not tested positive for COVID-19 since having the vaccine. Serious criteria was reported as death, hospitalization, life threatening. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Found dead

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