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

This is VAERS ID 1161850



Case Details

VAERS ID: 1161850 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
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 - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Drug ineffective
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: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: MTPFIZER INC2021343748

Write-up: had died from COVID-19 (despite being fully vaccinated) within 14 days; had died from COVID-19 (despite being fully vaccinated) within 14 days; This is a spontaneous report from a contactable physician via corporation sales representative. This physician reported similar events for 6 patients. This is the second of 6 reports. A 9-decade (over 80 years old) patient of an unspecified gender received BNT162B2 (COMIRNATY, solution for injection), dose 1 and dose 2, both via an unspecified route of administration on an unspecified date (Batch/Lot number and Expiration date were not reported) at single dose, for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient had died from COVID-19 (despite being fully vaccinated) within 14 days of taking the second dose. It was not reported if an autopsy was performed. Information on the lot/batch number has been requested.; Sender''s Comments: The causal relationship between BNT162B2 and the events drug ineffective and Covid 19 cannot be excluded as the information available in this report is limited and does not allow a medically meaningful assessment. This case will be reassessed once additional information becomes available. 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 and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : MT-PFIZER INC-2021338126 same reporter, same drug, same events, different patient; Reported Cause(s) of Death: had died from COVID-19 (despite being fully vaccinated) within 14 days; had died from COVID-19 (despite being fully vaccinated) within 14 days


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