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This is VAERS ID 1107693

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1107693
VAERS Form:2
Age:88.0
Sex:Female
Location:Foreign
Vaccinated:2021-02-23
Onset:2021-02-23
Submitted:0000-00-00
Entered:2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0725 / UNK RA / -

Administered by: Other      Purchased by: ??
Symptoms: Multiple organ dysfunction syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-24
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: Medical History/Concurrent Conditions: Arterial hypertension; Chronic atrial fibrillation; Cognitive deterioration; Renal impairment
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': ESPFIZER INC2021250311

Write-up: Multiple organ failure; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB ES-AEMPS-766497. A 88-year-old female patient received bnt162b2 (COMIRNATY, lot number: EL0725), via an unspecified route of administration (on right arm) on 23Feb2021 at SINGLE DOSE for covid-19 immunisation. Medical history included renal impairment, arterial hypertension, chronic atrial fibrillation and advanced cognitive deterioration, all on unknown dates. Concomitant medications were not reported. It was reported that the patient died within 24 hours after administration of the vaccine. The reporter believed the cause was multi-organ failure on 23Feb2021. The patient died on 24Feb2021. An autopsy was not performed.; Reported Cause(s) of Death: Multiple organ failure

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