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This is VAERS ID 1075434

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1075434
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

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

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: Medical History/Concurrent Conditions: Cervix carcinoma (status after Cervix-Ca)
Diagnostic Lab Data: Test Date: 20210122; Test Name: Sars-CoV2 test; Test Result: Positive
CDC 'Split Type': ATPFIZER INC2021221782

Write-up: Death/ Sars-CoV-2 infection positive; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB [AT-BASGAGES-2021-04879]. A 89-years-old female patient received bnt162b2 (COMIRNATY, batch/lot number: EL1491), via an unspecified route of administration on 15Jan2021 at single dose for covid-19 immunisation. Medical history included status after Cervix-Ca (not ongoing Cervix carcinoma). The patient''s concomitant medications were not reported. The patient experienced SARS-COV-2 test positive on 22Jan2021. The patient died on 27Jan2021 from COVID-19 respiratory infection (also reported the patient experienced death on 22Jan2021). The cause of death was SARS-COV-2 infection according to death certificate. It was not reported if an autopsy was performed. The patient''s outcome was fatal. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: COVID-19 respiratory infection

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