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This is VAERS ID 1113848

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First Appeared on 7/2/2021

VAERS ID: 1113848
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Dyspnoea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-17
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': NLPFIZER INC2021256593

Write-up: 2 weeks after vaccination dyspnoea; 2 weeks after vaccination fever; This is a spontaneous report from a contactable consumer received via the Regulatory Authority, downloaded from the Regulatory Authority-WEB. The regulatory authority report number is NL-LRB-00456375. An 85-year-old female patient received BNT162B2 (COMIRNATY, batch: unknown) via an unspecified route of administration on 29Jan2021 (unknown age at vaccination) at single dose for covid-19 immunization. The patient''s medical history and concomitant medications were not reported. The patient experienced 2 weeks after vaccination fever and 2 weeks after vaccination dyspnea, both on 17Feb2021. The patient died on 17Feb2021. The outcome of the events was fatal. It was unknown if an autopsy was performed. The reported cause of death was fever and dyspnea. No follow-up attempts are possible; information about batch/lot number cannot be obtained.; Reported Cause(s) of Death: fever; dyspnea

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