Your Health. Your Family. Your Choice.
|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH||- / 1||- / -|
Administered by: Other Purchased by: ??
Symptoms: COVID-19, SARS-CoV-2 test
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Preexisting Conditions: Medical History/Concurrent Conditions: Alzheimer''s disease; Memory loss; Comments: Patient has not had symptoms associated with COVID-19 Patient is not enrolled in clinical trial
Diagnostic Lab Data: Test Date: 20210125; Test Name: COVID-19 virus test; Result Unstructured Data: Test Result:Positive
CDC 'Split Type': GBPFIZER INC2021205310
Write-up: positive COVID-19 test; This is a spontaneous report from a contactable consumer received from the regulatory authority. Regulatory authority report number GB-MHRA-WEBCOVID-202102221318192820, Safety Report Unique Identifier GB-MHRA-ADR 24814558. An 84-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration at single dose on 19Jan2021 for covid-19 immunisation . Medical history included amnesia, dementia Alzheimer''s type. Concomitant medications were not reported. The patient experienced positive Covid-19 test on 25Jan2021. The patient died on 05Feb2021. It was not reported if an autopsy was performed. The patient had not had symptoms associated with COVID-19. The patient was not enrolled in a clinical trial. The reporter stated that: "My father was ok leading up to the vaccine he was quiet and tired due to boredom of being locked away in a care home unable to see relatives frequently or go outside and live a normal life". No follow-up attempts possible; information regarding batch/lot cannot be obtained; No further information expected.; Reported Cause(s) of Death: COVID-19
Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166