Your Health. Your Family. Your Choice.
|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH||EM0477 / 1||- / -|
Administered by: Other Purchased by: ??
Symptoms: Drug ineffective, COVID-19 pneumonia
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Preexisting Conditions: Medical History/Concurrent Conditions: Carcinoma prostate; Coronary heart disease; Dementia Alzheimer''s type; Diabetes mellitus; Hyperthyroidism; Left bundle branch block; Lumbalgia; Melanoma; Struma nodosa
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021160523
Write-up: Covid-19 Pneumonia; Covid-19 Pneumonia; This is a spontaneous report from a non-contactable physician downloaded from the regulatory authority-WEB with regulatory authority number DE-PEI-PEI2021002458. An 84 years old male patient received first dose of bnt162b2 (COMIRNATY, Solution for injection, lot/batch number: EM0477), via an unspecified route of administration on 01Jan2021 at single dose for covid-19 immunization. Medical history included diabetes mellitus, Dementia Alzheimer''s type, Hyperthyroidism, Struma nodosa, Coronary heart disease, Melanoma, Carcinoma prostate, Lumbalgia, Left bundle branch block, all from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. The patient experienced covid-19 pneumonia after vaccination on 26Jan2021. Death cause was reported as COVID-19 pneumonia. The patient died on 26Jan2021. It was not reported if an autopsy was performed. The outcome of the event was fatal. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: COVID-19 pneumonia
Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166