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This is VAERS ID 1064512

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1064512
VAERS Form:2
Age:97.0
Sex:Female
Location:Foreign
Vaccinated:2021-01-06
Onset:2021-01-27
Submitted:0000-00-00
Entered:2021-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6797 / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-27
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:
CDC 'Split Type': DEPFIZER INC2021199886

Write-up: Exitus letalis; This is a spontaneous report from a contactable physician downloaded from the regulatory authority-WEB DE-PEI-PEI2021002790. A female 97-years old patient received first dose of BNT162B2 (COMIRNATY) Lot number EJ6797, on 06Jan2021 at single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. 21 day(s) after vaccination (27Jan2021) the patient was dead (Exitus letalis). Autopsy was done and autopsy results was not available. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Death

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