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This is VAERS ID 1106072

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1106072
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-02-24
Onset:2021-02-25
Submitted:0000-00-00
Entered:2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-25
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: SINEMET; OMEPRAZOL
Current Illness:
Preexisting Conditions:
Allergies:
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

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