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This is VAERS ID 1174468

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1174468
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-03-24
Onset:2021-03-27
Submitted:0000-00-00
Entered:2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER7812 / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-27
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: Heart disorder
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021358270

Write-up: Death with unexplained cause of death; This is as spontaneous report received from a non-contactable consumer downloaded from the regulatory authority. The regulatory authority report number is DE-PEI-CADR2021039713. Safety report unique identifier DE-PEI-202100027344. An 80-year-old male patient received the first dose of bnt162b2 (COMIRNATY) lot number: ER7812, intramuscular on 24Mar2021 as single dose for Covid-19 immunisation. Medical history included ongoing cardiac disorder. Concomitant medications were not reported. The patient experienced death with unexplained cause of death. The patient died on 27Mar2021. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Unknown cause of death

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