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This is VAERS ID 1106961

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1106961
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-04
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:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021263397

Write-up: death; This is a spontaneous report received from a contactable physician based on information received by Pfizer. A female patient of an unspecified age received bnt162b2 (lot number and expiry date not reported), via an unspecified route of administration on Jan2021 at single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. The patient was not pregnant at the time of vaccination. The physician reported the death of a female doctor on 04Jan2021, who was apparently otherwise completely healthy and had been vaccinated with the vaccine days earlier. It was not reported if an autopsy was performed. Event occurred in a country different from that of the reporter. This may be a duplicate if the reporter also submitted directly to his/her local agency. No follow-up attempts are possible, information about lot/batch number cannot be obtained.; Sender''s Comments: The information in this report is limited, and does not allow a medically meaningful assessment of the case. In particular, the following information is not available: clinical course, concomitant medications, medical history, and autopsy results. The case will be reassessed should additional information become available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to committees and Investigators, as appropriate.; Reported Cause(s) of Death: death

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