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This is VAERS ID 1225084

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1225084
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-03-29
Onset:2021-03-31
Submitted:0000-00-00
Entered:2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-31
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: Medical History/Concurrent Conditions: Depression
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FRPFIZER INC2021398759

Write-up: Death NOS; This is a spontaneous report from a contactable consumer downloaded from a regulatory authority-WEB, regulatory authority number FR-AFSSAPS-LY20212736. An 86-year-old male patient received bnt162b2 (COMIRNATY), dose 1 intramuscular on 29Mar2021 (Batch/Lot number was not reported) as single dose for covid-19 immunization. Medical history included depression from an unknown date and unknown if ongoing. The patient had no history of COVID. The patient''s concomitant medications were not reported. The patient experienced death nos (no further information) on 31Mar2021. The patient died on 31Mar2021. It was not reported if an autopsy was performed. No follow-up attempts are possible; information on lot/batch number cannot be obtained.; Reported Cause(s) of Death: Death NOS

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1225084&WAYBACKHISTORY=ON

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