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This is VAERS ID 1316434

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1316434
VAERS Form:2
Age:94.0
Sex:Female
Location:Foreign
Vaccinated:2021-03-30
Onset:2021-04-07
Submitted:0000-00-00
Entered:2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER7812 / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Tremor

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-30
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: Medical History/Concurrent Conditions: Diabetes; Epilepsy (Last seizure 2010)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021522133

Write-up: Tremble; General debility; This is a spontaneous report received from a non-contactable physician downloaded from the Agency Regulatory Authority-WEB. The regulatory authority report number is DE-PEI-202100055350. A 94-year-old female patient received bnt162b2 (COMIRNATY), dose 2 via an unspecified route of administration on 30Mar2021 (Lot number ER7812) as 0.3 ml single dose for COVID-19 immunisation. The patient''s medical history included epilepsy (Last seizure 2010) and diabetes. The patient''s concomitant medications were not reported. The patient previously received bnt162b2 (COMIRNATY), dose 1 via an unspecified route of administration on 09Mar2021 as 0.3 ml single dose for COVID-19 immunisation. On 07Apr2021, the patient experienced fatal events general debility, tremble. The patient died on 30Apr2021. Cause of death also reported as unknown cause of death. Regulatory Authority assessed the relatedness of drug to reactions/events as D. Unclassifiable. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: general debility; tremble

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