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This is VAERS ID 1089902

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1089902
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Drug ineffective, Oxygen saturation, 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: Medical History/Concurrent Conditions: Living in nursing home
Diagnostic Lab Data: Test Date: 20210204; Test Name: desaturation; Test Result: 80 %
CDC 'Split Type': FRPFIZER INC2021250318

Write-up: COVID-19 respiratory infection; COVID-19 respiratory infection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB (FR-AFSSAPS-MA20210612). A 98-year-old female patient received the first dose of BNT162B2 (COMIRNATY; Lot number: EM0477), intramuscularly, on 19Jan2021 (at the age of 98-years-old) at a single dose for COVID-19 immunisation. Medical history included living in nursing home. The patient''s concomitant medications were not reported. The patient experienced COVID-19 respiratory infection on 04Feb2021, which was reported as fatal. It was reported that on day 16 of vaccination (day 1), there was appearance of a COVID-19 infection with 80% desaturation on 04Feb2021. The patient died on an unspecified date. The cause of death was assessed as COVID-19. It was not reported if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: COVID-19

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