National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1316438

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1316438
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other      Purchased by: ??
Symptoms: Asthenia, Chills, Dizziness, Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-02
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: Arterial hypertension; Coronary disease; Nicotine dependence
Preexisting Conditions: Medical History/Concurrent Conditions: Infarct myocardial
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021522124

Write-up: Death sudden; Light headedness; Chills; General debility; 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-202100056279. A 47-year-old female patient received BNT162B2 (COMIRNATY), via an unspecified route of administration on 28Apr2021 (Batch/Lot number was not reported) at 0.3ml single for COVID-19 immunisation. Medical history included ongoing arterial hypertension, ongoing nicotine dependence, infarct myocardial from Jan2020 to an unknown date, ongoing coronary disease. The patient''s concomitant medications were not reported. On 29Apr2021, the patient experienced general debility, light headedness, chills. On 02May2021, the patient experienced death sudden. It was not reported if an autopsy was performed. The patient''s outcome was fatal for general debility, fatal for light headedness, fatal for chills, fatal for death sudden. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Light headedness; Chills; General debility; Death sudden

New Search

Link To This Search Result:

Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166