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This is VAERS ID 1048262

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1048262
VAERS Form:2
Age:
Sex:Unknown
Location:Foreign
Vaccinated:2020-12-31
Onset:2021-01-12
Submitted:0000-00-00
Entered:2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM0477 / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Drug ineffective, COVID-19, Coronavirus test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-22
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:
Allergies:
Diagnostic Lab Data: Test Date: 20210112; Test Name: coronavirus rapid test; Test Result: Positive
CDC 'Split Type': DEPFIZER INC2021164941

Write-up: patient contracted Coronavirus/coronavirus rapid test: positive on 12Jan2021/symptoms were reported as loss of appetite and weakened; patient contracted Coronavirus/coronavirus rapid test: positive on 12Jan2021/symptoms were reported as loss of appetite and weakened; This is a spontaneous report from a non-contactable consumer based on information received by Pfizer from Biontech [manufacturer control number: 15873], license party for Comirnaty.This consumer reported similar events for 39 reports. This is the second of the 39 reports. A 78-year-old patient of an unspecified gender received bnt162b2 (COMIRNATY) lot# EM0477, via an unspecified route of administration on 31Dec2020 at single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced patient contracted coronavirus on 12Jan2021,symptoms were reported as loss of appetite and weakened. The patient underwent lab tests and procedures which included coronavirus rapid test: positive on 12Jan2021. The patient died on 22Jan2021. It was unknown if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Linked Report(s) : DE-PFIZER INC-2021164939 same reporter, same drug, different patients, similar events; Reported Cause(s) of Death: patient contracted Coronavirus/coronavirus rapid test: positive on 12Jan2021/symptoms were reported as loss of appetite and weakened; patient contracted Coronavirus/coronavirus rapid test: positive on 12Jan2021/symptoms were reported as loss of appet

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