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This is VAERS ID 1048251

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1048251
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Pyrexia, Renal failure, Urosepsis

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: Mental disability
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021160565

Write-up: Fever; Kidney failure; Urosepsis; This is a spontaneous report from a non-contactable consumer or other non hcp downloaded from the Agency Regulatory Authority-WEB DE-PEI-PEI2021002337. A 64-year-old male patient received bnt162b2 (COMIRNATY), via an unspecified route of administration on 14Jan2021 at single dose for covid-19 immunisation. Medical history included mental disability from an unknown date and unknown if ongoing. The patient''s concomitant medications were not reported. The patient experienced Fever and Renal failure and Urosepsis on an unspecified date, lasting for unknown. The patient died on 04Feb2021. An autopsy was not performed. No follow-up attempts are possible, information on batch number cannot be obtained.; Reported Cause(s) of Death: Fever; Urosepsis; Renal failure

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