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This is VAERS ID 1106959

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1106959
VAERS Form:2
Age:89.0
Sex:Male
Location:Foreign
Vaccinated:2021-02-18
Onset:2021-02-18
Submitted:0000-00-00
Entered:2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6789 / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Vaccination complication

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021250328

Write-up: Vaccination adverse reaction; This is a spontaneous report from a non-contactable physician downloaded from the Medicines Agency (EMA) EudraVigilance-WEB DE-PEI-PEI2021003143. An 89-year-old male patient received the first dose of bnt162b2 (COMIRNATY, lot number: EJ6789), via an unspecified route of administration on 18Feb2021 at SINGLE DOSE for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. On the same day after vaccination on 18Feb2021, the patient developed vaccination adverse reaction from which the patient died on 25Feb2021. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Vaccination adverse reaction

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