National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1112898

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1112898
VAERS Form:2
Age:72.0
Sex:Female
Location:Foreign
Vaccinated:2020-12-30
Onset:2021-01-08
Submitted:0000-00-00
Entered:2021-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Death, Dementia, Pyrexia, Unresponsive to stimuli, General physical health deterioration, Mental disorder, COVID-19, SARS-CoV-2 test positive, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-04
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Dementia; Hypertension
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210108; Test Name: Covid-Test; Result Unstructured Data: Test Result:Negative; Comments: one day later is the same Test pos.; Test Date: 20210109; Test Name: Covid-Test; Result Unstructured Data: Test Result:Positive; Comments: one day ago is the same Test neg.
CDC 'Split Type': DEPFIZER INC2021267011

Write-up: COVID-19 disease; Dementia aggravated; high fever; unresponsiveness; demented state, her mental as well as physical condition increasingly deteriorated; demented state, her mental as well as physical condition increasingly deteriorated; Unknown cause of death; This is a spontaneous report from a non-contactable consumer (patient''s son/daughter) downloaded from the Agency Regulatory agency-WEB regulatory authority number DE-CADRPEI-2021016548, and DE-PEI-2021006881. A 72-year-old female patient received the 1st dose of bnt162b2 (COMIRNATY) intramuscular on 30Dec2020 as 0.3 mL, single for COVID-19 immunisation. Medical history included ongoing hypertension, ongoing dementia. The patient''s concomitant medications were not reported. On 08Jan2021 the patient experienced COVID-19 disease, dementia aggravated, high fever, unresponsiveness and was hospitalized. Her demented state, her mental as well as physical condition increasingly deteriorated in 2021. The patient died on 04Feb2021 with unknown cause of death. It was not reported if an autopsy was performed. Course of events: On 08Jan2021 she was taken to the hospital due to high fever and unresponsiveness, on that day her Corona test was still negative, then positive the next day 09Jan2021, whereupon she was isolated. Due to the 2 weeks of isolation in her demented state, her mental as well as physical condition increasingly deteriorated. No further symptoms developed, and the fever continued for about 1 week. Reporter queried if it was possible that patient''s PCR test for the mRNA of the vaccine had an effect and if it could have been a vaccine reaction. She passed away on 04Feb2021. The causality for all events was considered as Unclassifiable. Follow-up activities not applicable, Follow-up provided automatically.; Reported Cause(s) of Death: Unknown cause of death

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1112898&WAYBACKHISTORY=ON

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166