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This is VAERS ID 1152875

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1152875
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK4238 / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Death, Ejection fraction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: Congestive heart failure (CHF EF 35%,); Hypertension; Paroxysmal supraventricular tachycardia
Allergies:
Diagnostic Lab Data: Test Name: EF; Test Result: 35 %
CDC 'Split Type': ILPFIZER INC2021330325

Write-up: was found lifeless at her home; This is a spontaneous report from a contactable other hcp received via regulatory authority. A 79-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot number EK4238) on an unknown date at single dose for COVID-19 immunization. medical history included congestive hear failure (CHF) EF 35%, hypertension, ventricular tachicardia paroxysmal. Concomitant drugs were unknown. The patient was found dead in her home 4 days after vaccination. No follow-up attempts possible. No information expected.; Sender''s Comments: Based on the information currently available, the patient''s underlying diseases might have contributed to patient''s demise. However, unless further information regarding specific cause of death provided, at present, the reported event death, cause unknown, is assessed as possibly related to suspect drug, as a cautionary measure and for reporting purposes. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, and Investigators, as appropriate and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : IL-PFIZER INC-2020517122 same source, diffrent patient; Reported Cause(s) of Death: was found lifeless at her home

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