National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 1075434

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1075434
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-01-15
Onset:2021-01-22
Submitted:0000-00-00
Entered:2021-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1491 / 1 - / -

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)
Allergies:
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

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1075434&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166