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This is VAERS ID 1110756

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1110756
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:2021-01-27
Submitted:0000-00-00
Entered:2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-27
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 INC2021120230

Write-up: Exitus letalis; This is a spontaneous report downloaded from The Regulatory Authority number: DE-PEI-PEI2021002011. A non-contactable physician reported that an 86 years old female patient received BNT162B2 (COMIRNATY) at single dose, on an unspecified date, for COVID-19 immunisation. Relevant medical history and concomitant medications were unknown. On 27Jan2021 after vaccination the patient died (death, exitus letalis was reported). It was unknown if autopsy was done. Death cause was reported as unknown cause of death. Reporter''s comment: another 3 patients died in the retirement home after the corona vaccination. Relatedness of drug to reaction/event Source of assessment: Regulatory Authority Result of Assessment: D. Unclassifiable No follow-up attempts are possible, information about lot number cannot be obtained.; Reporter''s Comments: Another 3 patients died in the retirement home after the corona vaccination.; Reported Cause(s) of Death: Unknown cause of death

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