National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 10/8/2021 release of VAERS data:

This is VAERS ID 1161668



Case Details

VAERS ID: 1161668 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-07
Onset:2021-01-31
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Chest X-ray, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-08
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Chest X-ray; Result Unstructured Data: Test Result:Unknown results; Test Date: 20210131; Test Name: COVID-19 virus test; Test Result: Positive ; Comments: Yes - Positive COVID-19 test
CDC Split Type: GBPFIZER INC2021334014

Write-up: SARS-CoV-2 infection/Vaccine breakthrough infection; SARS-CoV-2 infection/Vaccine breakthrough infection; This is a spontaneous report from a contactable healthcare professional received from the Regulatory Authority. The regulatory authority report number is GB-MHRA-WEBCOVID-202103231247133620, Safety Report Unique Identifier is GB-MHRA-ADR 25005489. An 86-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number and expiry date were not reported), via an unspecified route of administration on 07Jan2021 at a single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. It was unsure if patient has had symptoms associated with COVID-19. Patient was not enrolled in clinical trial. On 31Jan2021, the patient experienced SARS-CoV-2 infection/vaccine breakthrough infection. It was reported that the patient received COVID vaccine on 07Jan2021. Tested positive for COVID on 31Jan2021 and was admitted to hospital. Treated with antibiotics and dexamethasone. The reporter assessed the events as serious (hospitalization and death). The patient underwent lab tests and procedures which included chest x-ray: unknown results on an unspecified date and COVID-19 virus test: positive (yes/positive COVID-19 test) on 31Jan2021. The outcome of the events was fatal. The patient died on 08Feb2021 due to SARS-CoV-2 infection/vaccine breakthrough infection. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about batch/lot number cannot be obtained.; Reported Cause(s) of Death: SARS-CoV-2 infection/Vaccine breakthrough infection; SARS-CoV-2 infection/Vaccine breakthrough infection


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1161668

Government Disclaimer on use of this data


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