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This is VAERS ID 1316435

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1316435
VAERS Form:2
Age:81.0
Sex:Male
Location:Foreign
Vaccinated:2021-04-22
Onset:2021-04-27
Submitted:0000-00-00
Entered:2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET3045 / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-27
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: Parkinson''s disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021522129

Write-up: Unknown cause of death; This is a spontaneous report received from a non-contactable physician downloaded from the regulatory authority-WEB. The regulatory authority report number is DE-PEI-202100055353. An 81-year-old male patient received 2nd dose of BNT162B2 (COMIRNATY, lot number ET3045) at 0.3 ml single dose on 22Apr2021 for COVID-19 immunisation. Medical history and concurrent conditions included Parkinson''s disease. Concomitant drug was not provided. Historical vaccine included 1st dose of BNT162B2 (COMIRNATY) at 0.3 ml single dose on 25Mar2021 for COVID-19 immunisation. On 27Apr2021 the patient experienced unknown cause of death. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: unknown cause of death

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