National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1380078

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1380078
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-05-06
Onset:2021-05-12
Submitted:0000-00-00
Entered:2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EX6537 / UNK LA / OT

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-12
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': HUPFIZER INC2021628096

Write-up: Death; This is as spontaneous report received from a contactable physician downloaded from the Regualtory Authority-WEB. The regulatory authority report number is HU-OGYI-349621. A 64-year-old female patient received BNT162B2 (COMIRNATY, lot/batch EX6537) as 0,3ml single dose, on 06May2021, intramuscularly in the left arm for Covid-19 immunization. On 12May2021, the patient passed away. No other information was provided such as medical or concomitant drugs. It was unknown if an autopsy was performed. Sender''s Comments: Due to unsuccessful follow-up and lack of information, the case cannot be assessed, but is serious because the outcome was fatal. No follow-up attempts possible. No further information expected. ; Reported Cause(s) of Death: unknown cause of death

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1380078&WAYBACKHISTORY=ON


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