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This is VAERS ID 1206814

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1206814
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-03-16
Onset:2021-03-17
Submitted:0000-00-00
Entered:2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-17
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': NLPFIZER INC2021384544

Write-up: Sudden death; This is as spontaneous report received from a contactable consumer downloaded from the regulatory authority. The regulatory authority report number is NL-LRB-00492336. A 88-years-old male patient received dose 2 of bnt162b2 (COMIRNATY), via an unspecified route of administration on 16Mar2021 (Batch/Lot Number: Unknown) as SINGLE DOSE for covid-19 immunisation. Historical vaccine 1 dose of COMIRNATY for covid-19 immunisation: no adverse reaction. The patient medical history and concomitant medications were not reported. he patient experienced sudden death on 17Mar2021. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected. Information on lot and batch numbers cannot be obtained.; Reported Cause(s) of Death: died suddenly

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