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This is VAERS ID 1425718

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1425718
VAERS Form:2
Age:58.0
Sex:Female
Location:Foreign
Vaccinated:2021-05-26
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EY4835 / UNK - / OT

Administered by: Other      Purchased by: ??
Symptoms: Loss of consciousness

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': PHPFIZER INC2021717058

Write-up: Unconscious; This is a spontaneous report from a contactable physician. This is a report received from the Regulatory Authority. Regulatory authority report number PH-PHFDA-300083596. A 58-years-old female patient received BNT162B2 (COMIRNATY, Solution for injection), intramuscular on 26May2021 (Lot Number: EY4835) as dose number unknown, single (at age of 58-years-old) for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient experienced unconscious (death, medically significant) on 03Jun2021 07:30. The patient died on an unspecified date. It was not reported if an autopsy was performed. Outcome of the event was fatal. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Unconscious

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