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This is VAERS ID 1316445

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1316445
VAERS Form:2
Age:90.0
Sex:Female
Location:Foreign
Vaccinated:2021-02-05
Onset:2021-04-26
Submitted:0000-00-00
Entered:2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-26
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021527599

Write-up: Unknown cause of death; This is as spontaneous report from a non-contactable physician via Regulatory Authority, downloaded from the regulatory authority-WEB. The regulatory authority report number is DE-PEI-202100058011. A 91-year-old female patient received the second dose of BNT162B2 (COMIRNATY) via an unspecified route of administration on 05Feb2021 (at the age of 90-year-old) (Batch/Lot number was not reported) as single dose for COVID-19 immunisation. Relevant medical history and concomitant medications were not reported. The patient received the first dose of BNT162B2 (COMIRNATY) on 15Jan2021 at 0.3 ml single dose for COVID-19 immunisation. The patient experienced unknown cause of death on 26Apr2021. It was not reported if an autopsy was performed. Relatedness of drug to reaction(s)/event(s): Source of assessment: Regulatory Authority: Result of Assessment: D. Unclassifiable. No follow-up attempts are possible, information about batch number cannot be obtained.; Reported Cause(s) of Death: Unknown cause of death

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