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This is VAERS ID 1161303

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1161303
VAERS Form:2
Age:83.0
Sex:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2659 / 2 - / -

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

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021311585

Write-up: Death; This is a spontaneous report from a non-contactable physician downloaded from the Regulatory Authority-WEB. An 83-year-old female patient received second dose of (COMIRNATY), via an unspecified route of administration on 15Mar2021 (Lot Number: EJ6789 and ER2659 as reported) as SINGLE DOSE for COVID-19 immunisation. The patient previously had first dose of COMIRNATY on 22Feb2021 for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. Unknown after vaccination, the patient developed death on an unspecified date lasting for unknown (as reported). The patient died on an unspecified date. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Death

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1161303&WAYBACKHISTORY=ON

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