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This is VAERS ID 1377395

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1377395
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-01-23
Onset:2021-01-29
Submitted:0000-00-00
Entered:2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / OT

Administered by: Other      Purchased by: ??
Symptoms: Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-29
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': GBPFIZER INC2021617743

Write-up: Myocardial infarction; This is a spontaneous report received from a contactable physician from the Agency Regulatory Authority. The regulatory authority report number is GB-MHRA-ADR 25354584. A 74-year old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), intramuscularly on 23Jan2021 (Batch/Lot number was not reported) at 0.3 ml single for covid-19 immunisation. Relevant medical history and concomitant medications were not reported. The patient experienced myocardial infarction on 29Jan2021 which led to patient''s death on the same date. An autopsy was not performed. No follow-up attempts possible. No further information expected. Lot/Batch number cannot be obtained.; Reported Cause(s) of Death: Myocardial infarction

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