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This is VAERS ID 1421008

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/25/2021

VAERS ID: 1421008
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-03-22
Onset:2021-03-27
Submitted:0000-00-00
Entered:2021-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

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
Allergies:
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

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