Your Health. Your Family. Your Choice.
|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH||EW4109 / UNK||- / -|
Administered by: Other Purchased by: ??
Symptoms: Death, SARS-CoV-2 test
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Preexisting Conditions: Medical History/Concurrent Conditions: Overweight; Stroke
Diagnostic Lab Data: Test Name: COVID-19 virus test; Test Result: Negative
CDC 'Split Type': GBPFIZER INC2021617745
Write-up: Death; This is a spontaneous report received from a contactable physician from the Regulatory Authority (RA). The regulatory authority report number is GB-MHRA-WEBCOVID-202105261244255230-8FTBU, Safety Report Unique Identifier GB-MHRA-ADR 25364305. A 64-year old male patient received a dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE) via unspecified route of administration on 14May2021 (Batch/lot number EW4109) as single dose for Covid-19 immunization. relevant medical history included stroke in the past and very obese. The patient was found death at the toilet on 17May2021. A COVID-19 virus test performed on an unknown date was negative. Autopsy was not done. Cause of death was unknown. No follow-up attempts possible. No further information expected. Reported Cause(s) of Death: unknown cause of death.
Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166