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This is VAERS ID 1065562

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1065562
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Drug ineffective, General physical health deterioration, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-30
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:
Diagnostic Lab Data: Test Name: Nasopharyngeal pcr test; Test Result: Positive
CDC 'Split Type': BEPFIZER INC2021181924

Write-up: Drug ineffective; Nasopharyngeal pcr test on the 21st, which came back positive; Degradation of general condition; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB BE-FAMHP-DHH-N2021-76426, received from Regulatory Authority. An elderly patient of unspecified gender received BNT162B2 (COMIRNATY) via an unspecified route of administration on 13Jan2021 at single dose for COVID-19 immunisation. Medical history and concomitant mediations were unknown. The patient experienced COVID-19 virus test positive and degradation of general condition. The patient had nasopharyngeal pcr test on the 21st (unspecified date), which came back positive. The patient died on 30Jan2021. It was unknown if autopsy was performed. Outcome of the events was fatal. No follow-up attempts are possible, information on lot/batch number cannot be obtained.; Reported Cause(s) of Death: Drug ineffective; Nasopharyngeal pcr test on the 21st, which came back positive; degradation of general condition

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