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This is VAERS ID 1213645

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1213645
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-01-01
Onset:2021-01-30
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Death, General physical health deterioration

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-30
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': DEPFIZER INC2021389408

Write-up: Unknown cause of death; increasing deterioration; This is a spontaneous report from a non-contactable physician downloaded from a regulatory authority-WEB, regulatory authority number DE-PEI-PEI2021003965. A 95-year-old female patient received first dose bnt162b2 (COMIRNATY; Lot Number: not reported) intramuscular, on Jan2021, as SINGLE DOSE for covid-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications were not reported. On 30Jan2021, after vaccination, the patient developed Reduced general condition and Unknown cause of death. The patient died on 30Jan2021. The events were considered as serious (medically significant). Outcome of Reduced general condition was fatal. Causes of death was reported as unknown cause of death and Reduced general condition. It was unknown if an autopsy was performed. No follow-up attempts are possible, information on batch/lot number cannot be obtained.; Reported Cause(s) of Death: Unknown cause of death; Reduced general condition

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