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This is VAERS ID 1165549

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1165549
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-02-13
Onset:2021-02-18
Submitted:0000-00-00
Entered:2021-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Electrocardiogram, Myocardial infarction, Laboratory test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SIMVASTATIN; DARIFENACIN
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: ECG; Result Unstructured Data: Test Result:unknown result; Test Name: lab; Result Unstructured Data: Test Result:unknown result
CDC 'Split Type': NLPFIZER INC2021342698

Write-up: Myocardial infarct; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB, regulatory authority number NL-LRB-00483517. An 89-year-old female patient received first dose of BNT162B2 (COMIRNATY) via an unspecified route of administration on 13Feb2021 as single dose for covid-19 immunisation. The patient medical history was not reported. Patient had no COVID-19 infection previously. The patient has no past drug. Concomitant medications included simvastatin (10mg film-coated tablet); darifenacin (7.5mg modified-release tablet). The patient experienced myocardial infarct 5 days after BNT162B2 administration on 18Feb2021. The patient underwent lab tests and procedures which included examination at the cardiology department with electrocardiogram (ECG), lab (test), etc., with unknown results (undated). The patient died on an unspecified date. It was not reported if an autopsy was performed. The reported cause of death is Myocardial infarct. The outcome of myocardial infarct is fatal. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Myocardial infarct

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