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This is VAERS ID 1086540

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1086540
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-01-15
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1491 / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Cardio-respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-29
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: Arterial hypertension (Art HT); Atrial fibrillation (VHF); COPD (COPD); Palliative care (palliative Situation)
Preexisting Conditions: Medical History/Concurrent Conditions: Infarct cerebral (St.p. ischemic. Infarct); Pulmonary embolism (St p pulmonary embolism)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ATPFIZER INC2021242203

Write-up: Cardiovascular failure; This is a spontaneous report from a contactable physician via Regulatory Authority, downloaded from the Regulatory Authority (AT-BASGAGES-2021-07101). An 81-year-old female patient received the first dose of BNT162B2 (COMIRNATY; Lot number EL1491) via an unspecified route of administration on 15Jan2021 at single dose for COVID-19 immunisation. Relevant medical history included ongoing palliative care, ongoing arterial hypertension, ongoing chronic obstructive pulmonary disease (COPD), infarct cerebral (St.p. ischemic. Infarct) on an unspecified date and unknown if ongoing, pulmonary embolism on an unknown date and not ongoing (St p pulmonary embolism) and ongoing atrial fibrillation (VHF). Concomitant medications were not reported. In Jan2021, the patient experienced cardiovascular failure (cardio-respiratory arrest) with fatal outcome; the patient died on 29Jan2021. An autopsy was not performed. The patient was not suffering from COVID-19. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Cardiovascular failure

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