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This is VAERS ID 1381538

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1381538
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:0000-00-00
Onset:2021-04-27
Submitted:0000-00-00
Entered:2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Concomitant disease progression

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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': AUPFIZER INC2021634810

Write-up: Concomitant disease progression; This is a spontaneous report from a contactable other health professional via the Regulatory Authority. Regulatory Authority report number is 557868. An 89-year-old male patient received BNT162B2 (COMIRNATY) via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose (unknown if first or second dose) for COVID-19 immunisation. Relevant medical history and concomitant medications were not reported. On 27Apr2021, the patient experienced concomitant disease progression with fatal outcome on an unspecified date in 2021. It was not reported if an autopsy was performed. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Concomitant disease progression

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