National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1421008

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1421008
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-27
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: Bilateral blindness (glaucoma with blindness); Dementia; Hypertension
Preexisting Conditions: Medical History/Concurrent Conditions: Glaucoma
Diagnostic Lab Data:
CDC 'Split Type': DEPFIZER INC2021699254

Write-up: suddenly died; This is a spontaneous report downloaded from the WEB number DE-CADRPEI-2021093888, Safety Report Unique Identifier DE-PEI-202100087552. An 87-year-old female patient received first dose of BNT162B2 (COMIRNATY) via unspecified route 0.3ml twice daily for COVID-19 immunisation on 22Mar2021. Medical history included ongoing hypertension, ongoing bilateral blindness (glaucoma with blindness), ongoing dementia. The patient''s concomitant medications were not reported. The patient suddenly died 5 days after the corona vaccination on 27Mar2021, with outcome of the event was not resolved. The patient died on 27Mar2021. No autopsy was performed. Sender Comment: Information on risk factors or previous illnesses dementia, glaucoma with blindness, known and treated high blood pressure. Otherwise physically healthy. / actually no reaction until sudden death. Event assessment : Comirnaty/ event/PEI /Result of Assessment : D. Unclassifiable No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: suddenly died

New Search

Link To This Search Result:

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