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This is VAERS ID 1076912

History of Changes from the VAERS Wayback Machine

First Appeared on 3/11/2021

VAERS ID: 1076912
VAERS Form:2
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Drug ineffective, COVID-19

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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': USPFIZER INC2021224962

Write-up: died from COVID after receiving the two doses of the vaccine; COVID; This is a spontaneous report from a contactable consumer report for a friend. A patient of unspecified age and gender received first dose and second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) both via an unspecified route of administration on unspecified dates at single doses for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The consumer mentioned her friend died from COVID after receiving the two doses of the vaccine. The patient died on an unspecified date. It was unknown if an autopsy was performed. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: died from COVID after receiving the two doses of the vaccine


Changed on 5/7/2021

VAERS ID: 1076912 Before After
VAERS Form:2
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Drug ineffective, COVID-19

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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': USPFIZER INC2021224962

Write-up: died from COVID after receiving the two doses of the vaccine; COVID; This is a spontaneous report from a contactable consumer report for a friend. A patient of unspecified age and gender received first dose and second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) both via an unspecified route of administration on unspecified dates at single doses for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The consumer mentioned her friend died from COVID after receiving the two doses of the vaccine. The patient died on an unspecified date. It was unknown if an autopsy was performed. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: died from COVID after receiving the two doses of the vaccine


Changed on 5/14/2021

VAERS ID: 1076912 Before After
VAERS Form:2
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Drug ineffective, COVID-19

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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': USPFIZER INC2021224962

Write-up: died from COVID after receiving the two doses of the vaccine; COVID; This is a spontaneous report from a contactable consumer report for a friend. A patient of unspecified age and gender received first dose and second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) both via an unspecified route of administration on unspecified dates at single doses for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The consumer mentioned her friend died from COVID after receiving the two doses of the vaccine. The patient died on an unspecified date. It was unknown if an autopsy was performed. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: died from COVID after receiving the two doses of the vaccine

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1076912&WAYBACKHISTORY=ON

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