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This is VAERS ID 1055844

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1055844
VAERS Form:2
Age:86.0
Sex:Female
Location:Foreign
Vaccinated:2021-02-10
Onset:2021-02-12
Submitted:0000-00-00
Entered:2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-12
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: SIMVASTATIN; PRAMIPEXOL [PRAMIPEXOLE]; METOPROLOL; APIXABAN; LERCANIDIPINE; ISOSORBIDE; MOXONIDIN; L-DOPA
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Apoplexy; Artificial cardiac pacemaker user; Atrial fibrillation; COPD; Dementia; Hypertension arterial; Parkinson''s disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021173793

Write-up: Death sudden; This is a spontaneous report from a non-contactable physician downloaded from the Agency Regulatory Authority- WEB [DE-PEI-PEI2021002618] received via Regulatory Authority. An 86-year-old female patient received the first dose of bnt162b2 (COMIRNATY), via an unspecified route of administration at single dose on 10Feb2021 for covid-19 immunisation. Medical history included Parkinson''s disease, dementia, hypertension arterial, apoplexy, atrial fibrillation, artificial cardiac pacemaker user, COPD. Concomitant medication included simvastatin, pramipexol, metoprolol, apixaban, lercanidipine, isosorbide, moxonidine (MOXONIDIN), l-dopa. On 12Feb2021 after vaccination, the patient developed death sudden. The patient died on 12Feb2021. It was not reported if an autopsy was performed. Causality assessment by Agency for Comirnaty / Sudden death: D. Unclassifiable. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Sudden death

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