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This is VAERS ID 1297197

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1297197
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Pulmonary embolism

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: Dementia; Disease Parkinson''s
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021496539

Write-up: Lung embolism/suspected pulmonary embolism; This is a spontaneous report from a non-contactable consumer downloaded from the regulatory authority- DE-PEI-CADR2021059368. Safety Report Unique Identifier- DE-PEI-202100051095. An 86-year-old male patient received the second dose of BNT162B2 (COMIRNATY), via an unspecified route of administration on an unspecified date (Batch/Lot Number: Unknown) at single dose for covid-19 immunisation. Medical history included Disease Parkinson''s, dementia. The patient''s concomitant medications were not reported. The patient previously took the first dose of BNT162B2 (COMIRNATY) at 0.3ml, single for prophylactic vaccination. The patient experienced lung embolism on an unspecified date. About 4 weeks after the second vaccination with Comirnaty, the patient died with a suspected pulmonary embolism. The patient died on an unspecified date. It was not reported if an autopsy was performed. Source of assessment was PEI. Result was Unclassifiable. No follow-up attempts are possible; information about lot/batch number cannot be obtained. ; Reported Cause(s) of Death: Lung embolism/suspected pulmonary embolism

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