National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 10/15/2021 release of VAERS data:

This is VAERS ID 1202940



Case Details

VAERS ID: 1202940 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-03-01
Onset:2021-03-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP 2166 / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-01
   Days after onset: 0
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: Medical History/Concurrent Conditions: Metastatic uterine cancer
Allergies:
Diagnostic Lab Data:
CDC Split Type: SEPFIZER INC2021380320

Write-up: Death; This is a spontaneous report from a contactable physician downloaded from the regulatory authority, regulatory authority number SE-MPA-2021-021283. Other case identifier number SE-MPA-1616072349251. An 83-year-old female patient received bnt162b2 (COMIRNATY), dose 1 intramuscular in Mar2021 (Batch/Lot Number: EP 2166) as 0.3 mL, single for COVID-19 immunization. Medical history included metastatic uterine cancer with unspecified localization. There were no concomitant medications. The patient died in Mar2021 at home, seven days after her first dose of Comirnaty. It was unknown if an autopsy was performed. Outcome: Fatal. Report assessed as serious, death. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Death


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1202940

Government Disclaimer on use of this data


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