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This is VAERS ID 1433056

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1433056
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-05-07
Onset:2021-05-13
Submitted:0000-00-00
Entered:2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW6126 / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Aortic dissection, Cardiovascular disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-16
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': BEPFIZER INC2021752156

Write-up: Cardiovascular disorder; Aortic dissection; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB BE-FAMHP-DHH-N2021-96265. An 84-years-old female patient received bnt162b2 (COMIRNATY), dose 1 via an unspecified route of administration on 07May2021 (Lot Number: EW6126) as single dose for covid-19 immunisation. The patient medical history was not reported. The patient''s concomitant medications were not reported. The patient experienced cardiovascular disorder and aortic dissection, both on 13May2021. Patient received treatment, was hospitalization and surgery for treatment of aortic dissection. Evolution of the ADR: Death. The events resulted hospitalization and death. Patient died on 16May2021. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Aortic dissection; Cardiovascular disorder

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