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This is VAERS ID 1227970

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1227970
VAERS Form:2
Age:88.0
Sex:Female
Location:Ohio
Vaccinated:2021-03-03
Onset:2021-03-09
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 LA / -

Administered by: Unknown      Purchased by: ??
Symptoms: Brain stem stroke

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-03-11
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: LIPITOR [ATORVASTATIN]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (prior of vaccination)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC2021405473

Write-up: Mom died of a Brain Stem stroke; This is a spontaneous report from a contactable consumer (who reported for the mother). An 88-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration in the left arm on 03Mar2021 at 11:30 (at the age of 88-year-old) (Lot Number: EN6198) as single dose for COVID-19 immunisation. The patient was not tested for COVID-19 after vaccination. Relevant medical history included COVID-19 prior of vaccination. Concomitant medication included atorvastatin (LIPITOR) taken for an unspecified indication, start and stop date were not reported. On 09Mar2021 at 09:45, the patient experienced a brain stem stroke; the event required emergency room visit, the patient was hospitalized on 09Mar2021 and the event was considered serious also as life-threatening and causing disability. The patient received unspecified corrective treatments. The patient died due to brain stem stroke on 11Mar2021. An autopsy was not performed.; Reported Cause(s) of Death: Brain stem stroke


Changed on 5/7/2021

VAERS ID: 1227970 Before After
VAERS Form:2
Age:88.0
Sex:Female
Location:Ohio
Vaccinated:2021-03-03
Onset:2021-03-09
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 LA / -

Administered by: Unknown      Purchased by: ??
Symptoms: Brain stem stroke

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-03-11
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: LIPITOR [ATORVASTATIN]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (prior of vaccination)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC2021405473

Write-up: Mom died of a Brain Stem stroke; This is a spontaneous report from a contactable consumer (who reported for the mother). An 88-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration in the left arm on 03Mar2021 at 11:30 (at the age of 88-year-old) (Lot Number: EN6198) as single dose for COVID-19 immunisation. The patient was not tested for COVID-19 after vaccination. Relevant medical history included COVID-19 prior of vaccination. Concomitant medication included atorvastatin (LIPITOR) taken for an unspecified indication, start and stop date were not reported. On 09Mar2021 at 09:45, the patient experienced a brain stem stroke; the event required emergency room visit, the patient was hospitalized on 09Mar2021 and the event was considered serious also as life-threatening and causing disability. The patient received unspecified corrective treatments. The patient died due to brain stem stroke on 11Mar2021. An autopsy was not performed.; Reported Cause(s) of Death: Brain stem stroke


Changed on 5/14/2021

VAERS ID: 1227970 Before After
VAERS Form:2
Age:88.0
Sex:Female
Location:Ohio
Vaccinated:2021-03-03
Onset:2021-03-09
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 LA / -

Administered by: Unknown      Purchased by: ??
Symptoms: Brain stem stroke

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-03-11
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: LIPITOR [ATORVASTATIN]
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (prior of vaccination)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USPFIZER INC2021405473

Write-up: Mom died of a Brain Stem stroke; This is a spontaneous report from a contactable consumer (who reported for the mother). An 88-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration in the left arm on 03Mar2021 at 11:30 (at the age of 88-year-old) (Lot Number: EN6198) as single dose for COVID-19 immunisation. The patient was not tested for COVID-19 after vaccination. Relevant medical history included COVID-19 prior of vaccination. Concomitant medication included atorvastatin (LIPITOR) taken for an unspecified indication, start and stop date were not reported. On 09Mar2021 at 09:45, the patient experienced a brain stem stroke; the event required emergency room visit, the patient was hospitalized on 09Mar2021 and the event was considered serious also as life-threatening and causing disability. The patient received unspecified corrective treatments. The patient died due to brain stem stroke on 11Mar2021. An autopsy was not performed.; Reported Cause(s) of Death: Brain stem stroke

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