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This is VAERS ID 1048276

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1048276
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2020-12-31
Onset:2021-01-13
Submitted:0000-00-00
Entered:2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6797 / 1 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Death, COVID-19, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-13
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: COVID-19; General physical health deterioration; Living in nursing home (there was a covid-19 outbreak among several residents and staff)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 202101; Test Name: COVID-19 virus test; Test Result: Positive
CDC 'Split Type': DKPFIZER INC2021158625

Write-up: Covid-19; Death. It is not inconceivable that the total liability of Covid-19 disease and the vaccination has been fatal for the patient.; This is a spontaneous report downloaded from the Regulatory Authority-WEB DK-DKMA-ADR 24693323. The case was received from a contactable physician via The Agency. A 92-year-old female patient received the first dose of bnt162b2 (COMIRNATY, Lot number: ej6797, expiration date: 30Apr2021) intramuscular on 31Dec2020 at single dose for covid-19 immunisation. Medical history included patient concurrent conditions included Covid-19 and general physical health deterioration and Living in nursing home in which there was a covid-19 outbreak among several residents and staff. Concomitant medications were not provided. The patient was death on 13Jan2021, which the reporting physician described the occurrence of death, it is not inconceivable that the total liability of Covid-19 disease and the vaccination has been fatal for the patient, in a 92 years old female patient vaccinated with bnt162b2. Reported cause(es) of death: Death and of/with COVID-19. Only normal confirmation of death was performed post mortem. The patient underwent lab tests and procedures, which included Covid-19 test on Jan2021 as positive. The patient died on 13Jan2021. An autopsy was not performed and the reported cause of death was death and COVID-19. Causality from the reporter: it was not inconceivable that the total liability of Covid-19 disease and the vaccination has been fatal for the patient. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: COVID-19; Death

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