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This is VAERS ID 1121579

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1121579
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-03-01
Onset:2021-03-01
Submitted:0000-00-00
Entered:2021-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP2166 / UNK - / OT

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-01
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': SEPFIZER INC2021283331

Write-up: dead; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority, regulatory authority number SE-MPA-2021-012965. Other Case identifier number: SE-MPA-1615191743107. A 77-year-old male patient received BNT162B2 (COMIRNATY, Batch/Lot Number: EP2166), intramuscularly on Mar2021 at 0.3 mL, single for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported, no known underlying diseases. The patient received vaccine in Mar2021 in the afternoon, felt well at least until the next morning. Alone at home in the forenoon the next day. The patient was found dead early in the afternoon the day after the vaccination. Probably died before 12 o''clock. Report assessed as serious, death. The patient died in Mar2021. It was not reported if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: death

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