National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 10/15/2021 release of VAERS data:

This is VAERS ID 1106072

Case Details

VAERS ID: 1106072 (history)  
Form: Version 2.0  
Sex: Female  
Location: Foreign  
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-25
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SINEMET; OMEPRAZOL
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: NLPFIZER INC2021256570

Write-up: Death; Malaise; This is a spontaneous report from a contactable other healthcare professional via Regulatory Authority, downloaded from the Agency Regulatory Authority-WEB (NL-LRB-00463055). A 92-year-old female patient received BNT162B2 (COMIRNATY) via an unspecified route of administration on 24Feb2021 at single dose for COVID-19 immunisation. Relevant medical history was not reported. Concomitant medications included carbidopa/levodopa (SINEMET) 100mg/25mg and omeprazole (OMEPRAZOL) 20 mg. On 25Feb2021, the patient experienced malaise and died on the same date. The cause of death was unknown. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot and or batch number cannot be obtained.; Reported Cause(s) of Death: death

New Search

Link To This Search Result:

Government Disclaimer on use of this data

Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166