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This is VAERS ID 1174452

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1174452
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-02-18
Onset:2021-03-10
Submitted:0000-00-00
Entered:2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-10
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': CRPFIZER INC2021359751

Write-up: Patient died on 10Mar2021; This is a spontaneous report from a non-contactable consumer by regulatory authority. An 84-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date not provided), via an unspecified route of administration on 18Feb2021 at single dose for COVID-19 immunization. The patient''s medical history and concomitant medications were not reported. On 10Mar2021, the patient died. It was not reported if an autopsy was performed. No follow-up attempts are possible. No further information is expected, it is not possible to obtain information about lot/batch number.; Reported Cause(s) of Death: Patient died

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