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This is VAERS ID 1210316

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1210316
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Pulmonary embolism, Venous thrombosis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-09
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: THYROXIN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Hypothyroidism
Diagnostic Lab Data:
CDC 'Split Type': FIPFIZER INC2021389403

Write-up: Pulmonary embolism; Venous thrombosis; This is a spontaneous report from a contactable consumer downloaded from the regulatory authority. Regulatory authority number FI-FIMEA-20211617. This is a spontaneous report from a contactable consumer or other non hcp downloaded from the regulatory authority, regulatory authority number FI-FIMEA-20211617. A 80-years-old female patient received the first dose of bnt162b2 (COMIRNATY), via an unspecified route of administration on 04Mar2021 (at the age of 80) (Batch/Lot Number: UNKNOWN) as single dose for covid-19 immunisation. Medical history included hypothyroidism. Concomitant medication included levothyroxine sodium (THYROXIN) taken for hypothyroidism. Five days after taking the vaccine, on 09Mar2021, the patient was found dead at home. The patient experienced pulmonary embolism on 04Mar2021, venous thrombosis on 04Mar2021. The cause of death was determined in a forensic autopsy, and the cause of death was venous thrombosis and pulmonary embolism. Information about lot/batch number cannot be obtained. No further information expected.; Autopsy-determined Cause(s) of Death: Pulmonary embolism; Venous thrombosis

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