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This is VAERS ID 1100098

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1100098
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-02-26
Onset:2021-03-01
Submitted:0000-00-00
Entered:2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6136 / 1 LA / OT

Administered by: Other      Purchased by: ??
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-01
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': ITPFIZER INC2021256454

Write-up: Death from unspecified cause; This is a spontaneous report from a contactable physician (General Practitioner) downloaded from the regulatory authority-WEB, IT-MINISAL02-689813. A 95-year-old male patient received the first dose of BNT162B2 (COMIRNATY, lot number: EJ6136), intramuscularly in left deltoid on 26Feb2021 at single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient died on 01Mar2021 from unspecified cause. It was not reported if an autopsy was performed. Reporter Comment: On 03Mar2021 request for clinical report, on 04Mar2021 insertion of the reporter''s clinical report. Sender Comment: Spontaneous reporting form inserted in the regional vaccination register received following access by the local regulatory authority manager. No follow-up attempts are possible. No further information is expected.; Reporter''s Comments: On 03Mar2021 request for clinical report, on 04Mar2021 insertion of the reporter''s clinical report.; Reported Cause(s) of Death: Death from unspefied cause

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