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This is VAERS ID 1297192

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1297192
VAERS Form:2
Age:83.0
Sex:Female
Location:Foreign
Vaccinated:2021-04-08
Onset:2021-04-10
Submitted:0000-00-00
Entered:2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW8904 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-10
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: Anemia (Requires a transfusion); Atrioventricular block (NOS); Chronic atrial fibrillation; Chronic renal insufficiency; Decompensation cardiac; Left ventricular failure; Parkinson''s disease; Tachyarrhythmia absoluta
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021496543

Write-up: Unknown cause of death; This is a spontaneous report from a non-contactable physician downloaded from a regulatory authority-WEB, DE-PEI-202100051625. An 83-year-old female patient received BNT162B2 (COMIRNATY, 0.3 mL), via an unspecified route of administration on 08Apr2021 (at the age of 83-year-old) (Lot Number: EW8904) as single dose for covid-19 immunisation. Medical history included ongoing left ventricular failure, ongoing Parkinson''s disease, ongoing chronic atrial fibrillation, ongoing chronic renal insufficiency, ongoing anemia (required a transfusion), ongoing tachyarrhythmia absolute, ongoing decompensation cardiac, ongoing atrioventricular block (NOS). The patient''s concomitant medications were not reported. On 10Apr2021, the patient died due to unknown cause of death. The patient died on 10Apr2021. An autopsy was not performed. No follow-up attempts possible. No further information expected. ; Reported Cause(s) of Death: Unknown cause of death

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